Sample records for anoxia-induced prophase arrest

  1. α-endosulfine (ENSA) regulates exit from prophase I arrest in mouse oocytes


    Matthews, Lauren M; Evans, Janice P


    Mammalian oocytes in ovarian follicles are arrested in meiosis at prophase I. This arrest is maintained until ovulation, upon which the oocyte exits from this arrest, progresses through meiosis I and to metaphase of meiosis II. The progression from prophase I to metaphase II, known as meiotic maturation, is mediated by signals that coordinate these transitions in the life of the oocyte. ENSA (α-endosulfine) and ARPP19 (cAMP-regulated phosphoprotein-19) have emerged as regulators of M-phase, w...

  2. BubR1 is required for prophase I arrest and prometaphase progression during female meiosis I


    Homer, Hayden; Gui, Liming; Carroll, John


    Two critical stages of mammalian oocyte regulation are prophase I arrest, which is important for sustaining the oocyte pool, and meiosis I (MI), which produces fertilisable eggs. Here we find that the spindle assembly checkpoint protein, BubR1, regulates both stages in mouse oocytes. We show that oocytes depleted of BubR1 cannot sustain prophase I arrest and readily undergo germinal vesicle breakdown (GVBD), a marker for re-entry into MI. BubR1-depleted oocytes then arrest prior to completing...

  3. Prophase I arrest and progression to metaphase I in mouse oocytes: comparison of resumption of meiosis and recovery from G2-arrest in somatic cells

    Czech Academy of Sciences Publication Activity Database

    Šolc, Petr; Schultz, R. M.; Motlík, Jan


    Roč. 16, č. 9 (2010), s. 654-664 ISSN 1360-9947 R&D Projects: GA ČR(CZ) GC301/09/J036; GA MŠk ME08030 Grant - others:NIH(US) HD22681 Institutional research plan: CEZ:AV0Z50450515 Keywords : resumption of meiosis * prophase I arrest * oocyte Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 3.506, year: 2010

  4. Release from Xenopus oocyte prophase I meiotic arrest is independent of a decrease in cAMP levels or PKA activity. (United States)

    Nader, Nancy; Courjaret, Raphael; Dib, Maya; Kulkarni, Rashmi P; Machaca, Khaled


    Vertebrate oocytes arrest at prophase of meiosis I as a result of high levels of cyclic adenosine monophosphate (cAMP) and protein kinase A (PKA) activity. In Xenopus, progesterone is believed to release meiotic arrest by inhibiting adenylate cyclase, lowering cAMP levels and repressing PKA. However, the exact timing and extent of the cAMP decrease is unclear, with conflicting reports in the literature. Using various in vivo reporters for cAMP and PKA at the single-cell level in real time, we fail to detect any significant changes in cAMP or PKA in response to progesterone. More interestingly, there was no correlation between the levels of PKA inhibition and the release of meiotic arrest. Furthermore, we devised conditions whereby meiotic arrest could be released in the presence of sustained high levels of cAMP. Consistently, lowering endogenous cAMP levels by >65% for prolonged time periods failed to induce spontaneous maturation. These results argue that the release of oocyte meiotic arrest in Xenopus is independent of a reduction in either cAMP levels or PKA activity, but rather proceeds through a parallel cAMP/PKA-independent pathway. © 2016. Published by The Company of Biologists Ltd.

  5. Signaling-Mediated Regulation of Meiotic Prophase I and Transition During Oogenesis


    Arur, Swathi


    Generation of healthy oocytes requires coordinated regulation of multiple cellular events and signaling pathways. Oocytes undergo a unique developmental growth and differentiation pattern interspersed with long periods of arrest. Oocytes from almost all species arrest in prophase I of oogenesis that allows for long period of growth and differentiation essential for normal oocyte development. Depending on species, oocytes that transit from prophase I to meiosis I also arrest at meiosis I for f...

  6. Signaling-Mediated Regulation of Meiotic Prophase I and Transition During Oogenesis (United States)


    Generation of healthy oocytes requires coordinated regulation of multiple cellular events and signaling pathways. Oocytes undergo a unique developmental growth and differentiation pattern interspersed with long periods of arrest. Oocytes from almost all species arrest in prophase I of oogenesis that allows for long period of growth and differentiation essential for normal oocyte development. Depending on species, oocytes that transit from prophase I to meiosis I also arrest at meiosis I for fairly long periods of time and then undergo a second arrest at meiosis II that is completed upon fertilization. While there are species-specific differences in C. elegans, D. melanogaster, and mammalian oocytes in stages of prophase I, meiosis I, or meiosis II arrest, in all cases cell signaling pathways coordinate the developmental events controlling oocyte growth and differentiation to regulate these crucial phases of transition. In particular, the ERK MAP kinase signaling pathway, cyclic AMP second messengers, and the cell cycle regulators CDK1/cyclin B are key signaling pathways that seem evolutionarily conserved in their control of oocyte growth and meiotic maturation across species. Here, I identify the common themes and differences in the regulation of key meiotic events during oocyte growth and maturation. PMID:28247047

  7. Anoxia induces Ca2+ influx and loss of cell membrane integrity in rat extensor digitorum longus muscle. (United States)

    Fredsted, Anne; Mikkelsen, Ulla Ramer; Gissel, Hanne; Clausen, Torben


    Anoxia can lead to skeletal muscle damage. In this study we have investigated whether an increased influx of Ca2+, which is known to cause damage during electrical stimulation, is a causative factor in anoxia-induced muscle damage. Isolated extensor digitorum longus (EDL) muscles from 4-week-old Wistar rats were mounted at resting length and were either resting or stimulated (30 min, 40 Hz, 10 s on, 30 s off) in the presence of standard oxygenation (95% O2, 5% CO2), anoxia (95% N2, 5% CO2) or varying degrees of reduced oxygenation. At varying extracellular Ca2+ concentrations ([Ca2+]o), 45Ca influx and total cellular Ca2+ content were measured and the release of lactic acid dehydrogenase (LDH) was determined as an indicator of cell membrane leakage. In resting muscles, incubated at 1.3 mM Ca2+, 15-75 min of exposure to anoxia increased 45Ca influx by 46-129% (P<0.001) and Ca2+ content by 20-50% (P<0.001). Mg2+ (11.2 mM) reduced the anoxia-induced increase in 45Ca influx by 43% (P<0.001). In muscles incubated at 20 and 5% O2, 45Ca influx was also stimulated (P<0.001). Increasing [Ca2+]o to 5 mM induced a progressive increase in both 45Ca uptake and LDH release in resting anoxic muscles. When electrical stimulation was applied during anoxia, Ca2+ content and LDH release increased markedly and showed a significant correlation (r2=0.55, P<0.001). In conclusion, anoxia or incubation at 20 or 5% O2 leads to an increased influx of 45Ca. This is associated with a loss of cell membrane integrity, possibly initiated by Ca2+. The loss of cell membrane integrity further increases Ca2+ influx, which may elicit a self-amplifying process of cell membrane leakage.

  8. Tempol (4 hydroxy-tempo) inhibits anoxia-induced progression of mitochondrial dysfunction and associated neurobehavioral impairment in neonatal rats. (United States)

    Samaiya, Puneet K; Narayan, Gopeshwar; Kumar, Ashok; Krishnamurthy, Sairam


    Anoxia leads to a robust generation of reactive oxygen species/nitrogen species which can result in mitochondrial dysfunction and associated cell death in the cerebral cortex of neonates. The present study investigated the pharmacological role of tempol in the treatment of rat neonatal cortical mitochondrial dysfunction induced insult progression (day-1 to day-7) and associated neurobehavioral alterations post-anoxia. Rat pups of 30h age or postnatal day 2 (PND2) were randomly divided into 5 groups (n=5 per group): (1) Control; (2) Anoxia; (3) Anoxia+Tempol 75mg/kg; (4) Anoxia+Tempol 150mg/kg; and (5) Anoxia+Tempol 300mg/kg, and subjected to two episode of anoxia (10min each) at 24h of time interval in an enclosed chamber supplied with 100% N 2 . Tempol significantly decreased nitric oxide (NO) formation and simultaneously improved superoxide dismutase (SOD) and catalase (CAT) activities. Further, we observed a significantly (Ptempol. Furthermore, tempol decreased expression of mitochondrial Bax, cytochrome-C, caspase-9 and caspase-3 while the increase in expression of cytoplasmic Bax, mitochondrial Bcl-2 on day-7 in cortical region indicating regulation of intrinsic pathway of apoptosis. Further, it improved anoxia-induced neurobehavioral outcome (hanging and reflex latencies). Biochemical, molecular and behavioral studies suggest the role of tempol in preserving mitochondrial function and associated neurobehavioral outcomes after neonatal anoxia. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Meioc maintains an extended meiotic prophase I in mice. (United States)

    Soh, Y Q Shirleen; Mikedis, Maria M; Kojima, Mina; Godfrey, Alexander K; de Rooij, Dirk G; Page, David C


    The meiosis-specific chromosomal events of homolog pairing, synapsis, and recombination occur over an extended meiotic prophase I that is many times longer than prophase of mitosis. Here we show that, in mice, maintenance of an extended meiotic prophase I requires the gene Meioc, a germ-cell specific factor conserved in most metazoans. In mice, Meioc is expressed in male and female germ cells upon initiation of and throughout meiotic prophase I. Mouse germ cells lacking Meioc initiate meiosis: they undergo pre-meiotic DNA replication, they express proteins involved in synapsis and recombination, and a subset of cells progress as far as the zygotene stage of prophase I. However, cells in early meiotic prophase-as early as the preleptotene stage-proceed to condense their chromosomes and assemble a spindle, as if having progressed to metaphase. Meioc-deficient spermatocytes that have initiated synapsis mis-express CYCLIN A2, which is normally expressed in mitotic spermatogonia, suggesting a failure to properly transition to a meiotic cell cycle program. MEIOC interacts with YTHDC2, and the two proteins pull-down an overlapping set of mitosis-associated transcripts. We conclude that when the meiotic chromosomal program is initiated, Meioc is simultaneously induced so as to extend meiotic prophase. Specifically, MEIOC, together with YTHDC2, promotes a meiotic (as opposed to mitotic) cell cycle program via post-transcriptional control of their target transcripts.

  10. Ipl1/Aurora kinase suppresses S-CDK-driven spindle formation during prophase I to ensure chromosome integrity during meiosis.

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    Louise Newnham

    Full Text Available Cells coordinate spindle formation with DNA repair and morphological modifications to chromosomes prior to their segregation to prevent cell division with damaged chromosomes. Here we uncover a novel and unexpected role for Aurora kinase in preventing the formation of spindles by Clb5-CDK (S-CDK during meiotic prophase I and when the DDR is active in budding yeast. This is critical since S-CDK is essential for replication during premeiotic S-phase as well as double-strand break induction that facilitates meiotic recombination and, ultimately, chromosome segregation. Furthermore, we find that depletion of Cdc5 polo kinase activity delays spindle formation in DDR-arrested cells and that ectopic expression of Cdc5 in prophase I enhances spindle formation, when Ipl1 is depleted. Our findings establish a new paradigm for Aurora kinase function in both negative and positive regulation of spindle dynamics.

  11. Cytological techniques to study human female meiotic prophase. (United States)

    Roig, Ignasi; Garcia-Caldés, Montserrat


    Most of the human aneuploidies have a maternal origin. This feature makes the study of human female meiosis a fundamental topic to understand the reasons leading to this important social problem. Unfortunately, due to sample collection difficulties, not many studies have been performed on human female meiotic prophase. In this chapter we present a comprehensive collection of protocols that allows the study of human female meiotic prophase through different technical approaches using both spread and structurally preserved oocytes.

  12. Comparative Study on the Protective Effects of Salidroside and Hypoxic Preconditioning for Attenuating Anoxia-Induced Apoptosis in Pheochromocytoma (PC12) Cells. (United States)

    Hu, Yao; Lv, Xiumei; Zhang, Jing; Meng, Xianli


    BACKGROUND Hypoxia is an important sign that can result from body injuries or a special condition such as being at a high altitude or deep water diving. In the current studies, hypoxic preconditioning (HPC) plays a key role in reducing hypoxia-induced apoptosis. We aimed to study the pharmacologic preconditioning effects of salidroside versus those of HPC in hypoxia-/anoxia-induced apoptosis in PC12 cells (pheochromocytoma). MATERIAL AND METHODS PC12 cells were treated by different experimental conditions: control condition, hypoxia condition, HPC condition, low-/middle-/high-dose condition of salidroside, cyclosporine A (CsA), and oratractyloside (ATR). The cell viability, lactate dehydrogenase (LDH) activity, apoptosis, mitochondrial membrane potential (MMP), intracellular Ca2+, caspase-3 activity, and expression of Bcl-2 were detected in PC12 cells after the hypoxia treatment. Salidroside, extracted from the traditional Chinese herb Rhodiola rosea L, plays an essential role in reducing hypoxia-induced apoptosis in PC12 cells by the mitochondrial pathway. RESULTS Salidroside decreased the apoptosis and increased the viability of hypoxia-induced PC12 cells more effectively than HPC Moreover, salidroside markedly stabilized MMP and intracellular Ca2+, reduced or inhibited LDH and caspase-3 activity, and up-regulated Bcl-2; CsA and ATR showed corresponding function. CONCLUSIONS Salidroside administration restrains apoptosis induced by hypoxia in PC12 cells. The protective effects are mediated by preservation of mitochondrial integrity and MMP to inhibit the excessive Ca2+ influx and caspase-3 activity and to promote the Bcl-2 expression, providing a potential clinical and effective therapeutic mechanism to reduce deaths from ischemic or hypoxic injury.

  13. A Gene Regulatory Program for Meiotic Prophase in the Fetal Ovary

    NARCIS (Netherlands)

    Soh, Y Q Shirleen; Junker, Jan Philipp; Gill, Mark E; Mueller, Jacob L; van Oudenaarden, Alexander; Page, David C

    The chromosomal program of meiotic prophase, comprising events such as laying down of meiotic cohesins, synapsis between homologs, and homologous recombination, must be preceded and enabled by the regulated induction of meiotic prophase genes. This gene regulatory program is poorly understood,

  14. Nuclear Envelope-Associated Chromosome Dynamics during Meiotic Prophase I

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    Xinhua Zeng


    Full Text Available Chromosome dynamics during meiotic prophase I are associated with a series of major events such as chromosomal reorganization and condensation, pairing/synapsis and recombination of the homologs, and chromosome movements at the nuclear envelope (NE. The NE is the barrier separating the nucleus from the cytoplasm and thus plays a central role in NE-associated chromosomal movements during meiosis. Previous studies have shown in various species that NE-linked chromosome dynamics are actually driven by the cytoskeleton. The linker of nucleoskeleton and cytoskeleton (LINC complexes are important constituents of the NE that facilitate in the transfer of cytoskeletal forces across the NE to individual chromosomes. The LINCs consist of the inner and outer NE proteins Sad1/UNC-84 (SUN, and Klarsicht/Anc-1/Syne (KASH domain proteins. Meiosis-specific adaptations of the LINC components and unique modifications of the NE are required during chromosomal movements. Nonetheless, the actual role of the NE in chromosomic dynamic movements in plants remains elusive. This review summarizes the findings of recent studies on meiosis-specific constituents and modifications of the NE and corresponding nucleoplasmic/cytoplasmic adaptors being involved in NE-associated movement of meiotic chromosomes, as well as describes the potential molecular network of transferring cytoplasm-derived forces into meiotic chromosomes in model organisms. It helps to gain a better understanding of the NE-associated meiotic chromosomal movements in plants.

  15. Daily Arrests (United States)

    Montgomery County of Maryland — This dataset provides the public with arrest information from the Montgomery County Central Processing Unit (CPU) systems. The data presented is derived from every...

  16. A Gene Regulatory Program for Meiotic Prophase in the Fetal Ovary.

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    Y Q Shirleen Soh


    Full Text Available The chromosomal program of meiotic prophase, comprising events such as laying down of meiotic cohesins, synapsis between homologs, and homologous recombination, must be preceded and enabled by the regulated induction of meiotic prophase genes. This gene regulatory program is poorly understood, particularly in organisms with a segregated germline. We characterized the gene regulatory program of meiotic prophase as it occurs in the mouse fetal ovary. By profiling gene expression in the mouse fetal ovary in mutants with whole tissue and single-cell techniques, we identified 104 genes expressed specifically in pre-meiotic to pachytene germ cells. We characterized the regulation of these genes by 1 retinoic acid (RA, which induces meiosis, 2 Dazl, which is required for germ cell competence to respond to RA, and 3 Stra8, a downstream target of RA required for the chromosomal program of meiotic prophase. Initial induction of practically all identified meiotic prophase genes requires Dazl. In the presence of Dazl, RA induces at least two pathways: one Stra8-independent, and one Stra8-dependent. Genes vary in their induction by Stra8, spanning fully Stra8-independent, partially Stra8-independent, and fully Stra8-dependent. Thus, Stra8 regulates the entirety of the chromosomal program but plays a more nuanced role in governing the gene expression program. We propose that Stra8-independent gene expression enables the stockpiling of selected meiotic structural proteins prior to the commencement of the chromosomal program. Unexpectedly, we discovered that Stra8 is required for prompt down-regulation of itself and Rec8. Germ cells that have expressed and down-regulated Stra8 are refractory to further Stra8 expression. Negative feedback of Stra8, and subsequent resistance to further Stra8 expression, may ensure a single, restricted pulse of Stra8 expression. Collectively, our findings reveal a gene regulatory logic by which germ cells prepare for the

  17. Arresting Evolution. (United States)

    Bull, James J; Barrick, Jeffrey E


    Evolution in the form of selective breeding has long been harnessed as a useful tool by humans. However, rapid evolution can also be a danger to our health and a stumbling block for biotechnology. Unwanted evolution can underlie the emergence of drug and pesticide resistance, cancer, and weeds. It makes live vaccines and engineered cells inherently unreliable and unpredictable, and therefore potentially unsafe. Yet, there are strategies that have been and can possibly be used to stop or slow many types of evolution. We review and classify existing population genetics-inspired methods for arresting evolution. Then, we discuss how genome editing techniques enable a radically new set of approaches to limit evolution. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Apoptosis in mouse fetal and neonatal oocytes during meiotic prophase one

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    Hartshorne Geraldine M


    Full Text Available Abstract Background The vast majority of oocytes formed in the fetal ovary do not survive beyond birth. Possible reasons for their loss include the elimination of non-viable genetic constitutions arising through meiosis, however, the precise relationship between meiotic stages and prenatal apoptosis of oocytes remains elusive. We studied oocytes in mouse fetal and neonatal ovaries, 14.5–21 days post coitum, to examine the relationship between oocyte development and programmed cell death during meiotic prophase I. Results Microspreads of fetal and neonatal ovarian cells underwent immunocytochemistry for meiosis- and apoptosis-related markers. COR-1 (meiosis-specific highlighted axial elements of the synaptonemal complex and allowed definitive identification of the stages of meiotic prophase I. Labelling for cleaved poly-(ADP-ribose polymerase (PARP-1, an inactivated DNA repair protein, indicated apoptosis. The same oocytes were then labelled for DNA double strand breaks (DSBs using TUNEL. 1960 oocytes produced analysable results. Oocytes at all stages of meiotic prophase I stained for cleaved PARP-1 and/or TUNEL, or neither. Oocytes with fragmented (19.8% or compressed (21.2% axial elements showed slight but significant differences in staining for cleaved PARP-1 and TUNEL to those with intact elements. However, fragmentation of axial elements alone was not a good indicator of cell demise. Cleaved PARP-1 and TUNEL staining were not necessarily coincident, showing that TUNEL is not a reliable marker of apoptosis in oocytes. Conclusion Our data indicate that apoptosis can occur throughout meiotic prophase I in mouse fetal and early postnatal oocytes, with greatest incidence at the diplotene stage. Careful selection of appropriate markers for oocyte apoptosis is essential.

  19. Arabidopsis thaliana WAPL is essential for the prophase removal of cohesin during meiosis.

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    Kuntal De


    Full Text Available Sister chromatid cohesion, which is mediated by the cohesin complex, is essential for the proper segregation of chromosomes in mitosis and meiosis. The establishment of stable sister chromatid cohesion occurs during DNA replication and involves acetylation of the complex by the acetyltransferase CTF7. In higher eukaryotes, the majority of cohesin complexes are removed from chromosomes during prophase. Studies in fly and human have shown that this process involves the WAPL mediated opening of the cohesin ring at the junction between the SMC3 ATPase domain and the N-terminal domain of cohesin's α-kleisin subunit. We report here the isolation and detailed characterization of WAPL in Arabidopsis thaliana. We show that Arabidopsis contains two WAPL genes, which share overlapping functions. Plants in which both WAPL genes contain T-DNA insertions show relatively normal growth and development but exhibit a significant reduction in male and female fertility. The removal of cohesin from chromosomes during meiotic prophase is blocked in Atwapl mutants resulting in chromosome bridges, broken chromosomes and uneven chromosome segregation. In contrast, while subtle mitotic alterations are observed in some somatic cells, cohesin complexes appear to be removed normally. Finally, we show that mutations in AtWAPL suppress the lethality associated with inactivation of AtCTF7. Taken together our results demonstrate that WAPL plays a critical role in meiosis and raises the possibility that mechanisms involved in the prophase removal of cohesin may vary between mitosis and meiosis in plants.

  20. Circulatory Arrest, Brain Arrest and Death Determination

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    Sam David Shemie


    Full Text Available Technological advances, particularly in the capacity to support, replace or transplant failing organs, continue to challenge and refine our understanding of human death. Given the ability to reanimate organs before and after death, both inside and outside of the body, through reinstitution of oxygenated circulation, concepts related to death of organs (e.g. cardiac death are no longer valid. This paper advances the rationale for a single conceptual determination of death related to permanent brain arrest, resulting from primary brain injury or secondary to circulatory arrest. The clinical characteristics of brain arrest are the permanent loss of capacity for consciousness and loss of all brainstem functions. In the setting of circulatory arrest, death occurs after the arrest of circulation to the brain rather than death of the heart. Correspondingly, any intervention that resumes oxygenated circulation to the brain after circulatory arrest would invalidate the determination of death.

  1. Sequential Immunofluorescent Light Microscopy and Electron Microscopy of Recombination Nodules During Meiotic Prophase I. (United States)

    Anderson, Lorinda K


    Immunolocalization using either fluorescence for light microscopy (LM) or gold particles for electron microscopy (EM) has become a common tool to pinpoint proteins involved in recombination during meiotic prophase. Each method has its advantages and disadvantages. For example, LM immunofluorescence is comparatively easier and higher throughput compared to immunogold EM localization. In addition, immunofluorescence has the advantages that a faint signal can often be enhanced by longer exposure times and colocalization using two (or more) probes with different absorbance and emission spectra is straightforward. However, immunofluorescence is not useful if the object of interest does not label with an antibody probe and is below the resolution of the LM. In comparison, immunogold EM localization is higher resolution than immunofluorescent LM localization, and individual nuclear structures, such as recombination nodules, can be identified by EM regardless of whether they are labeled or not. However, immunogold localization has other disadvantages including comparatively low signal-to-noise ratios, more difficult colocalization using gold particles of different sizes, and the inability to evaluate labeling efficiency before examining the sample using EM (a more expensive and time-consuming technique than LM). Here we describe a method that takes advantage of the good points of both immunofluorescent LM and EM to analyze two classes of late recombination nodules (RNs), only one of which labels with antibodies to MLH1 protein, a marker of crossovers. The method can be used readily with other antibodies to analyze early recombination nodules or other prophase I structures.

  2. Histone H2AFX Links Meiotic Chromosome Asynapsis to Prophase I Oocyte Loss in Mammals.

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    Jeffrey M Cloutier


    Full Text Available Chromosome abnormalities are common in the human population, causing germ cell loss at meiotic prophase I and infertility. The mechanisms driving this loss are unknown, but persistent meiotic DNA damage and asynapsis may be triggers. Here we investigate the contribution of these lesions to oocyte elimination in mice with chromosome abnormalities, e.g. Turner syndrome (XO and translocations. We show that asynapsed chromosomes trigger oocyte elimination at diplonema, which is linked to the presence of phosphorylated H2AFX (γH2AFX. We find that DNA double-strand break (DSB foci disappear on asynapsed chromosomes during pachynema, excluding persistent DNA damage as a likely cause, and demonstrating the existence in mammalian oocytes of a repair pathway for asynapsis-associated DNA DSBs. Importantly, deletion or point mutation of H2afx restores oocyte numbers in XO females to wild type (XX levels. Unexpectedly, we find that asynapsed supernumerary chromosomes do not elicit prophase I loss, despite being enriched for γH2AFX and other checkpoint proteins. These results suggest that oocyte loss cannot be explained simply by asynapsis checkpoint models, but is related to the gene content of asynapsed chromosomes. A similar mechanistic basis for oocyte loss may operate in humans with chromosome abnormalities.

  3. Global transcriptome analysis of two ameiotic1 alleles in maize anthers: defining steps in meiotic entry and progression through prophase I

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    Fernandes John F


    Full Text Available Abstract Background Developmental cues to start meiosis occur late in plants. Ameiotic1 (Am1 encodes a plant-specific nuclear protein (AM1 required for meiotic entry and progression through early prophase I. Pollen mother cells (PMCs remain mitotic in most am1 mutants including am1-489, while am1-praI permits meiotic entry but PMCs arrest at the leptotene/zygotene (L/Z transition, defining the roles of AM1 protein in two distinct steps of meiosis. To gain more insights into the roles of AM1 in the transcriptional pre-meiotic and meiotic programs, we report here an in depth analysis of gene expression alterations in carefully staged anthers at 1 mm (meiotic entry and 1.5 mm (L/Z caused by each of these am1 alleles. Results 1.0 mm and 1.5 mm anthers of am1-489 and am1-praI were profiled in comparison to fertile siblings on Agilent® 4 × 44 K microarrays. Both am1-489 and am1-praI anthers are cytologically normal at 1.0 mm and show moderate transcriptome alterations. At the 1.5-mm stage both mutants are aberrant cytologically, and show more drastic transcriptome changes. There are substantially more absolute On/Off and twice as many differentially expressed genes (sterile versus fertile in am1-489 than in am1-praI. At 1.5 mm a total of 4,418 genes are up- or down-regulated in either am1-489 or am1-praI anthers. These are predominantly stage-specific transcripts. Many putative meiosis-related genes were found among them including a small subset of allele-specific, mis-regulated genes specific to the PMCs. Nearly 60% of transcriptome changes in the set of transcripts mis-regulated in both mutants (N = 530 are enriched in PMCs, and only 1% are enriched in the tapetal cell transcriptome. All array data reported herein will be deposited and accessible at MaizeGDB Conclusions Our analysis of anther transcriptome modulations by two distinct am1 alleles, am1-489 and am1-praI, redefines the role of AM1 as a modulator of expression

  4. Sequential loading of cohesin subunits during the first meiotic prophase of grasshoppers. (United States)

    Valdeolmillos, Ana M; Viera, Alberto; Page, Jesús; Prieto, Ignacio; Santos, Juan L; Parra, María Teresa; Heck, Margarete M S; Martínez-A, Carlos; Barbero, José L; Suja, José A; Rufas, Julio S


    The cohesin complexes play a key role in chromosome segregation during both mitosis and meiosis. They establish sister chromatid cohesion between duplicating DNA molecules during S-phase, but they also have an important role during postreplicative double-strand break repair in mitosis, as well as during recombination between homologous chromosomes in meiosis. An additional function in meiosis is related to the sister kinetochore cohesion, so they can be pulled by microtubules to the same pole at anaphase I. Data about the dynamics of cohesin subunits during meiosis are scarce; therefore, it is of great interest to characterize how the formation of the cohesin complexes is achieved in order to understand the roles of the different subunits within them. We have investigated the spatio-temporal distribution of three different cohesin subunits in prophase I grasshopper spermatocytes. We found that structural maintenance of chromosome protein 3 (SMC3) appears as early as preleptotene, and its localization resembles the location of the unsynapsed axial elements, whereas radiation-sensitive mutant 21 (RAD21) (sister chromatid cohesion protein 1, SCC1) and stromal antigen protein 1 (SA1) (sister chromatid cohesion protein 3, SCC3) are not visualized until zygotene, since they are located in the synapsed regions of the bivalents. During pachytene, the distribution of the three cohesin subunits is very similar and all appear along the trajectories of the lateral elements of the autosomal synaptonemal complexes. However, whereas SMC3 also appears over the single and unsynapsed X chromosome, RAD21 and SA1 do not. We conclude that the loading of SMC3 and the non-SMC subunits, RAD21 and SA1, occurs in different steps throughout prophase I grasshopper meiosis. These results strongly suggest the participation of SMC3 in the initial cohesin axis formation as early as preleptotene, thus contributing to sister chromatid cohesion, with a later association of both RAD21 and SA1

  5. Sequential loading of cohesin subunits during the first meiotic prophase of grasshoppers.

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    Ana M Valdeolmillos


    Full Text Available The cohesin complexes play a key role in chromosome segregation during both mitosis and meiosis. They establish sister chromatid cohesion between duplicating DNA molecules during S-phase, but they also have an important role during postreplicative double-strand break repair in mitosis, as well as during recombination between homologous chromosomes in meiosis. An additional function in meiosis is related to the sister kinetochore cohesion, so they can be pulled by microtubules to the same pole at anaphase I. Data about the dynamics of cohesin subunits during meiosis are scarce; therefore, it is of great interest to characterize how the formation of the cohesin complexes is achieved in order to understand the roles of the different subunits within them. We have investigated the spatio-temporal distribution of three different cohesin subunits in prophase I grasshopper spermatocytes. We found that structural maintenance of chromosome protein 3 (SMC3 appears as early as preleptotene, and its localization resembles the location of the unsynapsed axial elements, whereas radiation-sensitive mutant 21 (RAD21 (sister chromatid cohesion protein 1, SCC1 and stromal antigen protein 1 (SA1 (sister chromatid cohesion protein 3, SCC3 are not visualized until zygotene, since they are located in the synapsed regions of the bivalents. During pachytene, the distribution of the three cohesin subunits is very similar and all appear along the trajectories of the lateral elements of the autosomal synaptonemal complexes. However, whereas SMC3 also appears over the single and unsynapsed X chromosome, RAD21 and SA1 do not. We conclude that the loading of SMC3 and the non-SMC subunits, RAD21 and SA1, occurs in different steps throughout prophase I grasshopper meiosis. These results strongly suggest the participation of SMC3 in the initial cohesin axis formation as early as preleptotene, thus contributing to sister chromatid cohesion, with a later association of both RAD21

  6. Basal aurora kinase B activity is sufficient for histone H3 phosphorylation in prophase

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    Ly-Thuy-Tram Le


    Histone H3 phosphorylation is the hallmark of mitosis deposited by aurora kinase B. Benzo[e]pyridoindoles are a family of potent, broad, ATP-competitive aurora kinase inhibitors. However, benzo[e]pyridoindole C4 only inhibits histone H3 phosphorylation in prophase but not in metaphase. Under the C4 treatment, the cells enter into mitosis with dephosphorylated histone H3, assemble chromosomes normally and progress to metaphase, and then to anaphase. C4 also induces lagging chromosome in anaphase but we demonstrated that these chromosome compaction defects are not related to the absence of H3 phosphorylation in prophase. As a result of C4 action, mitosis lasts longer and the cell cycle is slowed down. We reproduced the mitotic defects with reduced concentrations of potent pan aurora kinase as well as with a specific aurora B ATP-competitive inhibitor; we therefore propose that histone H3 phosphorylation and anaphase chromosome compaction involve the basal activity of aurora kinase B. Our data suggest that aurora kinase B is progressively activated at mitosis entry and at anaphase onset. The full activation of aurora kinase B by its partners, in prometaphase, induces a shift in the catalytic domain of aurora B that modifies its affinity for ATP. These waves of activation/deactivation of aurora B correspond to different conformations of the chromosomal complex revealed by FRAP. The presence of lagging chromosomes may have deleterious consequences on the daughter cells and, unfortunately, the situation may be encountered in patients receiving treatment with aurora kinase inhibitors.

  7. Prophase I Mouse Oocytes Are Deficient in the Ability to Respond to Fertilization by Decreasing Membrane Receptivity to Sperm and Establishing a Membrane Block to Polyspermy1 (United States)

    Kryzak, Cassie A.; Moraine, Maia M.; Kyle, Diane D.; Lee, Hyo J.; Cubeñas-Potts, Caelin; Robinson, Douglas N.; Evans, Janice P.


    ABSTRACT Changes occurring as the prophase I oocyte matures to metaphase II are critical for the acquisition of competence for normal egg activation and early embryogenesis. A prophase I oocyte cannot respond to a fertilizing sperm as a metaphase II egg does, including the ability to prevent polyspermic fertilization. Studies here demonstrate that the competence for the membrane block to polyspermy is deficient in prophase I mouse oocytes. In vitro fertilization experiments using identical insemination conditions result in monospermy in 87% of zona pellucida (ZP)-free metaphase II eggs, while 92% of ZP-free prophase I oocytes have four or more fused sperm. The membrane block is associated with a postfertilization reduction in the capacity to support sperm binding, but this reduction in sperm-binding capacity is both less robust and slower to develop in fertilized prophase I oocytes. Fertilization of oocytes is dependent on the tetraspanin CD9, but little to no release of CD9 from the oocyte membrane is detected, suggesting that release of CD9-containing vesicles is not essential for fertilization. The deficiency in membrane block establishment in prophase I oocytes correlates with abnormalities in two postfertilization cytoskeletal changes: sperm-induced cortical remodeling that results in fertilization cone formation and a postfertilization increase in effective cortical tension. These data indicate that cortical maturation is a component of cytoplasmic maturation during the oocyte-to-egg transition and that the egg cortex has to be appropriately primed and tuned to be responsive to a fertilizing sperm. PMID:23863404

  8. Pittsburgh Police Arrest Data (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Arrest data contains information on people taken into custody by City of Pittsburgh police officers. More serious crimes such as felony offenses are more likely to...

  9. A yeast's eye view of mammalian reproduction: cross-species gene co-expression in meiotic prophase

    Directory of Open Access Journals (Sweden)

    Li Yunfei


    Full Text Available Abstract Background Meiotic prophase is a critical stage in sexual reproduction. Aberrant chromosome recombination during this stage is a leading cause of human miscarriages and birth defects. However, due to the experimental intractability of mammalian gonads, only a very limited number of meiotic genes have been characterized. Here we aim to identify novel meiotic genes important in human reproduction through computational mining of cross-species and cross-sex time-series expression data from budding yeast, mouse postnatal testis, mouse embryonic ovary, and human fetal ovary. Results Orthologous gene pairs were ranked by order statistics according to their co-expression profiles across species, allowing us to infer conserved meiotic genes despite obvious differences in cellular synchronicity and composition in organisms. We demonstrated that conserved co-expression networks could successfully recover known meiotic genes, including homologous recombination genes, chromatin cohesion genes, and genes regulating meiotic entry. We also showed that conserved co-expression pairs exhibit functional connections, as evidenced by the annotation similarity in Gene Ontology and overlap with physical interactions. More importantly, we predicted six new meiotic genes through their co-expression linkages with known meiotic genes, and subsequently used the genetically more amenable yeast system for experimental validation. The deletion mutants of all six genes showed sporulation defects, equivalent to a 100% validation rate. Conclusions We identified evolutionarily conserved gene modules in meiotic prophase by integrating cross-species and cross-sex expression profiles from budding yeast, mouse, and human. Our co-expression linkage analyses confirmed known meiotic genes and identified several novel genes that might be critical players in meiosis in multiple species. These results demonstrate that our approach is highly efficient to discover evolutionarily

  10. Ipl1/Aurora Kinase Suppresses S-CDK-Driven Spindle Formation during Prophase I to Ensure Chromosome Integrity during Meiosis


    Newnham, Louise; Jordan, Philip W.; Carballo, Jesus A.; Newcombe, Sonya; Hoffmann, Eva


    Cells coordinate spindle formation with DNA repair and morphological modifications to chromosomes prior to their segregation to prevent cell division with damaged chromosomes. Here we uncover a novel and unexpected role for Aurora kinase in preventing the formation of spindles by Clb5-CDK (S-CDK) during meiotic prophase I and when the DDR is active in budding yeast. This is critical since S-CDK is essential for replication during premeiotic S-phase as well as double-strand break induction tha...

  11. Genetic probing of homologous recombination and non-homologous end joining during meiotic prophase in irradiated mouse spermatocytes

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, Emad A. [Department of Endocrinology and Metabolism, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH Utrecht (Netherlands); Department of Zoology, Faculty of Science, Assiut University, 71516 Assiut (Egypt); Philippens, Marielle E.P.; Kal, Henk B. [Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Rooij, Dirk G. de, E-mail: [Department of Endocrinology and Metabolism, Faculty of Science, Utrecht University, Padualaan 8, 3584 CH Utrecht (Netherlands); Center for Reproductive Medicine, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam (Netherlands); Boer, Peter de [Department of Obstetrics and Gynaecology, Radboud University Nijmegen Medical Centre, 6500 HB Nijmegen (Netherlands)


    This study was designed to obtain a better insight into the relative contribution of homologous recombination (HR) and non-homologous end joining (NHEJ) to the repair of radiation-induced DNA double-strand breaks (DSBs) at first meiotic prophase. Early and late pachytene and early diplotene spermatocytes that had completed crossing over were sampled. We studied the kinetics of {gamma}-H2AX chromatin foci removal after irradiation of mice deficient for HR and mice deficient for NHEJ. Analyzing {gamma}-H2AX signals in unirradiated RAD54/RAD54B deficient spermatocytes indicated incomplete meiotic recombination repair due to the pronounced increase of {gamma}-H2AX foci in late prophase primary spermatocytes. In these mice, 8 h after irradiation, early pachytene spermatocytes showed a reduction of the numbers of {gamma}-H2AX foci by 52% compared to 82% in the wild type, the difference being significant. However, after crossing over (in late pachytene and early diplotene), no effect of RAD54/RAD54B deficiency on the reduction of irradiation-induced foci was observed. In NHEJ deficient SCID mice, repair kinetics in early spermatocytes were similar to those in wild type mice. However, 1 h after irradiation in late pachytene and early diplotene spermatocytes 1.7 times more foci were found than in wild type mice. This difference might be related to the absence of a DNA-PKcs dependent fast repair component in SCID mice. As subsequent repair is normal, HR likely is taking over. Taken together, the results obtained in RAD54/RAD54B deficient mice and in SCID mice indicate that DSB repair in early pachytene spermatocytes is mainly carried out through HR. In late spermatocytes (late pachytenes and early diplotenes) NHEJ is active. However, probably there is an interplay between these repair pathways and when in late spermatocytes the NHEJ pathway is compromised HR may take over.

  12. Genetic probing of homologous recombination and non-homologous end joining during meiotic prophase in irradiated mouse spermatocytes. (United States)

    Ahmed, Emad A; Philippens, Marielle E P; Kal, Henk B; de Rooij, Dirk G; de Boer, Peter


    This study was designed to obtain a better insight into the relative contribution of homologous recombination (HR) and non-homologous end joining (NHEJ) to the repair of radiation-induced DNA double-strand breaks (DSBs) at first meiotic prophase. Early and late pachytene and early diplotene spermatocytes that had completed crossing over were sampled. We studied the kinetics of gamma-H2AX chromatin foci removal after irradiation of mice deficient for HR and mice deficient for NHEJ. Analyzing gamma-H2AX signals in unirradiated RAD54/RAD54B deficient spermatocytes indicated incomplete meiotic recombination repair due to the pronounced increase of gamma-H2AX foci in late prophase primary spermatocytes. In these mice, 8h after irradiation, early pachytene spermatocytes showed a reduction of the numbers of gamma-H2AX foci by 52% compared to 82% in the wild type, the difference being significant. However, after crossing over (in late pachytene and early diplotene), no effect of RAD54/RAD54B deficiency on the reduction of irradiation-induced foci was observed. In NHEJ deficient SCID mice, repair kinetics in early spermatocytes were similar to those in wild type mice. However, 1h after irradiation in late pachytene and early diplotene spermatocytes 1.7 times more foci were found than in wild type mice. This difference might be related to the absence of a DNA-PKcs dependent fast repair component in SCID mice. As subsequent repair is normal, HR likely is taking over. Taken together, the results obtained in RAD54/RAD54B deficient mice and in SCID mice indicate that DSB repair in early pachytene spermatocytes is mainly carried out through HR. In late spermatocytes (late pachytenes and early diplotenes) NHEJ is active. However, probably there is an interplay between these repair pathways and when in late spermatocytes the NHEJ pathway is compromised HR may take over. Copyright 2010 Elsevier B.V. All rights reserved.

  13. The ATM signaling cascade promotes recombination-dependent pachytene arrest in mouse spermatocytes.

    Directory of Open Access Journals (Sweden)

    Sarai Pacheco


    Full Text Available Most mutations that compromise meiotic recombination or synapsis in mouse spermatocytes result in arrest and apoptosis at the pachytene stage of the first meiotic prophase. Two main mechanisms are thought to trigger arrest: one independent of the double-strand breaks (DSBs that initiate meiotic recombination, and another activated by persistent recombination intermediates. Mechanisms underlying the recombination-dependent arrest response are not well understood, so we sought to identify factors involved by examining mutants deficient for TRIP13, a conserved AAA+ ATPase required for the completion of meiotic DSB repair. We find that spermatocytes with a hypomorphic Trip13 mutation (Trip13mod/mod arrest with features characteristic of early pachynema in wild type, namely, fully synapsed chromosomes without incorporation of the histone variant H1t into chromatin. These cells then undergo apoptosis, possibly in response to the arrest or in response to a defect in sex body formation. However, TRIP13-deficient cells that additionally lack the DSB-responsive kinase ATM progress further, reaching an H1t-positive stage (i.e., similar to mid/late pachynema in wild type despite the presence of unrepaired DSBs. TRIP13-deficient spermatocytes also progress to an H1t-positive stage if ATM activity is attenuated by hypomorphic mutations in Mre11 or Nbs1 or by elimination of the ATM-effector kinase CHK2. These mutant backgrounds nonetheless experience an apoptotic block to further spermatogenic progression, most likely caused by failure to form a sex body. DSB numbers are elevated in Mre11 and Nbs1 hypomorphs but not Chk2 mutants, thus delineating genetic requirements for the ATM-dependent negative feedback loop that regulates DSB numbers. The findings demonstrate for the first time that ATM-dependent signaling enforces the normal pachytene response to persistent recombination intermediates. Our work supports the conclusion that recombination defects trigger

  14. Cardiac arrest – cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Basri Lenjani


    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 min from attack, which implies that if cardiac arrest occurs near an institution health care (with an opportunity to provide the emergent health care the rate of survival is higher.

  15. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore


    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  16. Application studies of line arresters

    Energy Technology Data Exchange (ETDEWEB)

    Zanetta Junior, Luiz Cera; Pereira, Carlos Eduardo de Morais [Sao Paulo Univ., SP (Brazil). Escola Politecnica. Dept. de Engenharia de Energia e Automacao Eletricas]. E-mail:


    This paper presents the main calculations of the line arresters impact on outage rates, by focusing their effects on critical current curves, in presence of the power frequency voltage. The present critical results obtained will help in the understanding of some variables during the outrage calculations. Energy stresses on arresters due to first stroke are also evaluated in function of tower foot resistance. The transmission line studied, has a shielded 138 kV line configuration, single circuit typical of Brazilian SE region. The alternative with Zn O arresters consider their installation at every tower, in the two lower phases b and c. (author)

  17. Problems of house arrest application

    Directory of Open Access Journals (Sweden)

    Mikhail Vladimirovich Kolesnikov


    Full Text Available Objective to determine the position of house arrest in the system of preventive measures and to identify the main problems of criminal procedural regulation that prevent its broader use during the preliminary investigation and trial. Methods dialectical approach to the analysis of social phenomena allowing to view them in static and dynamic aspect evolutionarysynergetic paradigm providing the opportunity to explore the phenomenon under investigation with respect to the system subordinate and coordinating relationships within the system. Dialectical approach and the evolutionarysynergetic paradigm determined the choice of specific methods of research historical comparative law comparative formallegal statistical. Results the problems arising with application of house arrest are grouped by author depending on the structure of the provisions of Article 107 of the CriminalProcedural Code of the Russian Federation. The first group of problems includes the determination of the location of the accused suspect under house arrest and the scope of the legal restrictions imposed. The second group includes the establishment of terms of house arrest and their subsequent renewal or change of the preventive measure. The third group is the identification of persons to which the house arrest will be the best preventive measure. The results of the study allow to make proposals to change the current wording of Art. 107 of the CriminalProcedural Code of Russia. Scientific novelty a comprehensive study of current state of the normativelegal regulation of house arrest in the context of its practical application. Practical value the main provisions and conclusions of the article can be used in scientific and pedagogical activity when considering questions about the nature of preventive measures related to the restraint of personal liberty of the accused. nbsp

  18. An airline cardiac arrest program. (United States)

    O'Rourke, M F; Donaldson, E; Geddes, J S


    As many as 1000 lives are lost annually from cardiac arrest in commercial aircraft. Ventricular fibrillation (VF), the most common mechanism, can be treated effectively only with prompt defibrillation, whereas the current policy of most airlines is to continue cardiopulmonary resuscitation pending aircraft diversion. The objective of this study was to assess the impact of making semiautomatic external defibrillators (AEDs) available for use on airline passengers with cardiac arrest. AEDs were installed on international Qantas aircraft and at major terminals, selected crew were trained in their use, and all crew members were trained in cardiopulmonary resuscitation. Supervision was provided by medical volunteers or (remotely) by airline physicians. During a 64-month period, AEDs were used on 109 occasions: 63 times for monitoring an acutely ill passenger and 46 times for cardiac arrest. Twenty-seven episodes of cardiac arrest occurred in aircraft, often (11 of 27 [41%]) unwitnessed, and they were usually (21 of 27 [78%]) associated with asystole or pulseless idioventricular rhythm. All 19 arrests in terminals were witnessed; VF was present in 17 (89%). Overall, defibrillation was initially successful in 21 of 23 cases (91%). Long-term survival from VF was achieved in 26% (2 of 6 in aircraft and 4 of 17 in terminals). The ability to monitor cardiac rhythm aided decisions on diversion, which was avoided in most passengers with asystole or idioventricular rhythm. AEDs in aircraft and terminals, with appropriate crew training, are helpful in the management of cardiac emergencies. Survival from VF is practicable and is comparable with the most effective prehospital ambulance emergency services. Costly aircraft diversions can be avoided in clearly futile situations, enhancing the cost-effectiveness of the program.

  19. Out-of-hospital Cardiac Arrest (OHCA) Biomarkers (United States)


    Neurological Outcome; Cardiac Arrest; Out-Of-Hospital Cardiac Arrest; Brain Anoxia Ischemia; Hypoxia, Brain; Hypoxia-Ischemia, Brain; Cardiac Arrest With Successful Resuscitation; Cardiac Arrest, Out-Of-Hospital; Brain Injuries

  20. Prediction of cardiac arrest recurrence using ensemble classifiers

    Indian Academy of Sciences (India)

    Nachiket Tapas

    Abstract. Inability of a heart to contract effectually or its failure to contract prevents blood from circulating efficiently, causing circulatory arrest or cardiac arrest or cardiopulmonary arrest. The unexpected cardiac arrest is medically referred to as sudden cardiac arrest (SCA). Poor survival rate of patients with SCA is one of the.

  1. Arrested segregative phase separation in capillary tubes

    NARCIS (Netherlands)

    Tromp, R. Hans; Lindhoud, Saskia


    Phase separation in a capillary tube with one of the phases fully wetting the capillary wall is arrested when the typical size of the phase domains reaches the value of the diameter of the tube. The arrested state consists of an alternating sequence of concave-capped and convex-capped cylindrical

  2. Cardiorespiratory arrest in children (out of hospital)


    Writer, Hilary


    Cardiorespiratory arrest outside hospital occurs in approximately 1/10,000 children a year in resource-rich countries, with two thirds of arrests occurring in children under 18 months of age. Approximately 40% of cases have undetermined causes, including sudden infant death syndrome . Of the rest, 20% are caused by trauma, 10% by chronic disease, and 6% by pneumonia.

  3. Cardiorespiratory arrest in children (out of hospital)


    Writer, Hilary


    Cardiorespiratory arrest outside hospital occurs in approximately 1/10,000 children a year in resource-rich countries, with two-thirds of arrests occurring in children under 18 months of age. Approximately 45% of cases have undetermined causes, including sudden infant death syndrome. Of the rest, 20% are caused by trauma, 10% by chronic disease, and 6% by pneumonia.

  4. Juvenile Arrests, 2000. Juvenile Justice Bulletin. (United States)

    Snyder, Howard N.

    This bulletin examines the national and state juvenile arrest rate in 2000 using data reported annually by local law enforcement agencies nationwide to the FBI's Uniform Crime Reporting program. Results indicate that the murder rate in 2000 was the lowest since 1965; juvenile arrests for violence in 2000 were the lowest since 1988; few juveniles…

  5. Psychopathology in Women Arrested for Domestic Violence (United States)

    Stuart, Gregory L.; Moore, Todd M.; Gordon, Kristina Coop; Ramsey, Susan E.; Kahler, Christopher W.


    This study examined the prevalence of psychopathology among women arrested for violence and whether the experience of intimate partner violence (IPV) was associated with Axis I psychopathology. Women who were arrested for domestic violence perpetration and court referred to violence intervention programs (N=103) completed measures of IPV…

  6. [Cardiorespiratory arrest in children with trauma]. (United States)

    López-Herce Cid, J; Domínguez Sampedro, P; Rodríguez Núñez, A; García Sanz, C; Carrillo Alvarez, A; Calvo Macías, C; Bellón Cano, J M


    To analyze the characteristics and outcome of cardiorespiratory arrest secondary to trauma in children. We performed a secondary analysis of data from a prospective, multicenter study of cardiorespiratory arrest in children. Data were recorded according to the Utstein style. Twenty-eight children (age range: 7 days to 16 years) with cardiorespiratory arrest secondary to trauma were evaluated. The outcome variables were return of spontaneous circulation, sustained (more than 20 minutes) return of spontaneous circulation (initial survival), and survival at hospital discharge (final survival) in relation to the characteristics of the cardiorespiratory arrest and cardiopulmonary resuscitation. Neurological and general performance outcome was assessed by means of the Pediatric Cerebral Performance Category scale and the Pediatric Overall Performance Category scale. Return of spontaneous circulation was obtained in 18 patients (64.2 %), initial survival was achieved in 14 (50 %) and final survival was achieved in three (10.7 %) (two without neurological sequelae and one with vegetative status). Final survival was significantly higher in patients with respiratory arrest (33.3 %) than in those with cardiac arrest (4.5 %), p = 0.04. Final survival was also higher in patients with a duration of cardiopulmonary resuscitation shorter than 20 minutes (27.2 %) than in the remaining patients (0 %), p =0.05. The two survivors without neurologic sequelae had respiratory arrest. Survival until hospital discharge in children with cardiorespiratory arrest secondary to trauma is lower than that in children with cardiorespiratory arrest. Patients with respiratory arrest when resuscitation is started and those with a duration of cardiopulmonary resuscitation of less than 20 minutes showed better survival than the remaining patients.

  7. Sexual dimorphism in prophase I of meiosis in the Northern mole vole (Ellobius talpinus Pallas, 1770 with isomorphic (XX chromosomes in males and females

    Directory of Open Access Journals (Sweden)

    O Kolomiets


    Full Text Available The synaptonemal complex (SC surface-spreading technique was used to visualize the process of chromosome synapsis in spermatocytes and oocytes of E. talpinus Pallas, 1770, a species with the XX sex chromosome system in both males and females. We used electron microscopy and immunofluorescent localization of synaptonemal complex protein (SCP3 and centromeric proteins to analyze the structure and behaviour of synaptonemal complexes in prophase I of meiosis, aiming to reveal signs of meiotic sexual dimorphism in this species. We present evidence of considerable differences in the structure and behaviour of the axial structures of sex bivalents in male and female meiosis, despite the isomorphic G- and C-banding patterns of mitotic sex chromosomes. During meiotic prophase I, the sex bivalent in females behaved as autosomal bivalents, but it was not involved in the formation of the bouquet configuration or it was the first to leave it. The XX chromosomes of males formed closed sex bivalents. Only short tracts of SC were formed at both ends of the sex bivalent, while large middle segments of the lateral elements remained unpaired. The male sex chromosomes also formed characteristic “sex bodies”. In fact, electron microscopy revealed dense nucleolus-like bodies associated with unpaired parts of the axial elements. These regions of the sex chromosomes were poorly immunostained, because the distribution of SCP3 had a peculiar powder-like pattern, but SCP3 was not associated with the nucleolus-like bodies. We also revealed signs of sexual dimorphism in the dynamics of formation and destruction of autosomal SCs. In males, the total SC length was shorter than in females. The chromosome bouquet configuration was preserved up to the stage of early pachytene in females. The bouquet configuration in males was not expressed. At late pachytene, gaps were revealed in the structure of autosomal SCs in spermatocytes immunostained with antibodies to SCP3. The

  8. Comparison of crack arrest methodologies

    International Nuclear Information System (INIS)



    The ASTM Cooperative Test Program Data were used to compare the static (K/sub Ia/) and dynamic (K/sud ID/, K/sub IDm/) approaches to crack arrest. K/sub Ia/ is not dependent on K/sub Q/. This is consistent with the requirements of the static approach, but not the dynamic one which requires that K/sub Ia/ decrease with K/sub Q/ if K/sub ID/ (= K/sub IDm/) is a constant. K/sub ID/ increases systematically with K/sub Q/ at a rate that is consistent with calculations based on the use of a constant value for K/sub Ia/ which is equal to its measured mean value. Only in the limiting case of very short crack jumps (associated with very low average crack speeds) can K/sub ID/ be identified as a minimum value at which K/sub ID/ = K/sub IDm/. In this case K/sub IDm/ approx. K/sub Ia/ approx. K/sub Im/. The latter is the idealized minimum value of K that will support the continued propagation of a running crack

  9. Spatiotemporal Stability of Public Cardiac Arrests

    NARCIS (Netherlands)

    Demirtas, Derya; Brooks, Steven C.; Morrison, Laurie J.; Chan, Timothy C.Y.


    Background: Public access automated external defibrillator (AED) deployment and community cardiopulmonary resuscitation (CPR) programs should target geographical areas with high risk of out-of-hospital cardiac arrest (OHCA). Although these long-term, location-based interventions implicitly assume

  10. Composite Pressure Vessel Including Crack Arresting Barrier (United States)

    DeLay, Thomas K. (Inventor)


    A pressure vessel includes a ported fitting having an annular flange formed on an end thereof and a tank that envelopes the annular flange. A crack arresting barrier is bonded to and forming a lining of the tank within the outer surface thereof. The crack arresting barrier includes a cured resin having a post-curing ductility rating of at least approximately 60% through the cured resin, and further includes randomly-oriented fibers positioned in and throughout the cured resin.

  11. Sex Disparities in Arrest Outcomes for Domestic Violence (United States)

    Hamilton, Melissa; Worthen, Meredith G. F.


    Domestic violence arrests have been historically focused on protecting women and children from abusive men. Arrest patterns continue to reflect this bias with more men arrested for domestic violence compared to women. Such potential gender variations in arrest patterns pave the way to the investigation of disparities by sex of the offender in…

  12. Cardiac arrest leadership: in need of resuscitation? (United States)

    Robinson, Philip S; Shall, Emma; Rakhit, Roby


    Leadership skills directly correlate with the quality of technical performance of cardiopulmonary resuscitation (CPR) and clinical outcomes. Despite an improved focus on non-technical skills in CPR training, the leadership of cardiac arrests is often variable. To assess the perceptions of leadership and team working among members of a cardiac arrest team and to evaluate future training needs. Cross-sectional survey of 102 members of a cardiac arrest team at an Acute Hospital Trust in the UK with 892 inpatient beds. Responses sought from doctors, nurses and healthcare assistants to 12 rated statements and 4 dichotomous questions. Of 102 responses, 81 (79%) were from doctors and 21 (21%) from nurses. Among specialist registrars 90% agreed or strongly agreed that there was clear leadership at all arrests compared with between 28% and 49% of nurses and junior doctors respectively. Routine omission of key leadership tasks was reported by as many as 80% of junior doctors and 50% of nurses. Almost half of respondents reported non-adherence with Advanced Life Support (ALS) guidelines. Among junior members of the team, 36% felt confident to lead an arrest and 75% would welcome further dedicated cardiac arrest leadership training. Leadership training is integrated into the ALS (Resus Council, UK) qualification. However, this paper found that in spite of this training; standards of leadership are variable. The findings suggest a pressing need for further dedicated cardiac arrest leadership training with a focus on improving key leadership tasks such as role assignment, team briefing and debriefing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  13. Arrested larval development in cattle nematodes. (United States)

    Armour, J; Duncan, M


    Most economically important cattle nematodes are able to arrest their larval development within the host - entering a period of dormancy or hypobiosis. Arrested larvae have a low death rate, and large numbers can accumulate in infected cattle during the grazing season. Because of this, outbreaks of disease caused by such nematodes can occur at times when recent infection with the parasites could not have occurred, for example during winter in temperature northern climates when cattle are normally housed. The capacity to arrest is a heritable trait. It is seen as an adaptation by the parasite to avoid further development to its free-living stages during times when the climate is unsuitable for free-living survival. But levels of arrestment can vary markedly in different regions, in different cattle, and under different management regimes. Climatic factors, previous conditioning, host immune status, and farm management all seem to affect arrestment levels. In this article, James Armour and Mary Duncan review the biological basis of the phenomenon, and discuss the apparently conflicting views on how it is controlled.

  14. Characteristics and outcome of cardiorespiratory arrest in children. (United States)

    López-Herce, Jesús; García, Cristina; Domínguez, Pedro; Carrillo, Angel; Rodríguez-Núñez, Antonio; Calvo, Custodio; Delgado, Miguel Angel


    To analyse the present day characteristics and outcome of cardio-respiratory arrest in children in Spain. An 18-month prospective, multicentre study analysing out-of-hospital and in-hospital cardio-respiratory arrest in children. Two hundred and eighty-three children between 7 days and 17 years of age with cardio-respiratory arrest. Data were recorded according to the Utstein style. The outcome variables were the sustained return of spontaneous circulation (initial survival), and survival at 1 year (final survival). Three hundred and eleven cardio-respiratory arrest episodes, composed of 70 respiratory arrests and 241 cardiac arrests in 283 children were studied. Accidents were the most frequent cause of out-of-hospital arrest (40%), and cardiac disease was the leading cause (31%) of in-hospital arrest. Initial survival was 60.2% and 1 year survival was 33.2%. The final survival was higher in patients with respiratory arrest (70%) than in patients with cardiac arrest (21.1%) (P arrest in children remains high. Survival after respiratory arrest is significantly higher than after cardiac arrest. The duration of cardiopulmonary resuscitation attempt is the best indicator of mortality of cardio-respiratory arrest in children.

  15. Miller Fisher syndrome with sinus arrest

    Directory of Open Access Journals (Sweden)

    Nobuko Shiraiwa


    Full Text Available Dysautonomia in Guillain-Barre syndrome (GBS rarely causes serious cardiovascular complications, such as sinus arrest. Miller Fisher syndrome (MFS is recognized as a variant of GBS. There have been few reports regarding the association between MFS and dysautonomia. We describe a case of a 68-year-old man with ophthalmoplegia, bulbar palsy, truncal ataxia, and areflexia. He was diagnosed with MFS because he exhibited the classical clinical triad and had elevated serum anti- GQ1b immunoglobulin G levels. A magnetic resonance imaging scan of his head was normal. His 24-hour Holter recording showed sinus arrest. He was treated with intravenous immunoglobulin, whereupon his symptoms gradually improved. This included the sinus arrest, which was considered a symptom of dysautonomia in MFS. Therefore, clinicians should be mindful of dysautonomia not only in GBS patients, but also in cases of MFS.

  16. The CYCLIN-A CYCA1;2/TAM Is Required for the Meiosis I to Meiosis II Transition and Cooperates with OSD1 for the Prophase to First Meiotic Division Transition


    d'Erfurth, Isabelle; Cromer, Laurence; Jolivet, Sylvie; Girard, Chlo?; Horlow, Christine; Sun, Yujin; To, Jennifer P. C.; Berchowitz, Luke E.; Copenhaver, Gregory P.; Mercier, Raphael


    Meiosis halves the chromosome number because its two divisions follow a single round of DNA replication. This process involves two cell transitions, the transition from prophase to the first meiotic division (meiosis I) and the unique meiosis I to meiosis II transition. We show here that the A-type cyclin CYCA1;2/TAM plays a major role in both transitions in Arabidopsis. A series of tam mutants failed to enter meiosis II and thus produced diploid spores and functional diploid gametes. These d...

  17. House Arrest: Florida's Community Control Program. (United States)

    Chi, Keon S.

    This report highlights Florida's house arrest program, a new alternative to prison incarceration viewed as a significant criminal justice experiment. The implementation and operation of the community control program is decribed, specific goals and objectives of the community control program are listed, and a preliminary assessment is offered.…

  18. [Extracorporeal life support for treating cardiac arrest]. (United States)

    Lehot, Jean-Jacques; Long-Him-Nam, Nelly; Bastien, Olivier


    Percutaneous extracorporeal life support (ECLS) is now widespread for treating acute cardiac failure. ECLS has been used for treating in-hospital and out of hospital cardiac arrests. A systematic review of literature was performed in order to assess the results. Nine studies of in-hospital cardiac arrests were published between 2003 and January 31, 2011. They included 724 patients, 208 of which survived without significant neurological sequelae (28.7 %). In the other patients, the initial disease and the consequences of low flow brought multiorgan failure, or ECLS resulted in haemorrhage and ischaemia. Low flow lasted between 42 and 105 min (mean 54min). ECLS was used after out of hospital cardiac arrests in 3 studies published between 2008 and January 31, 2011. They included 110 patients of which only 6 survived (4.4 %) despite strict inclusion criteria. Low flow lasted between 60 and 120 min (mean 98 min.) According to these results the use of ECLS should be encouraged after in-hospital cardiac arrest and training in cardiorespiratory resuscitation should be improved in global population and health professionals.

  19. Cardiac Arrest After Submucosal Infiltration With Lignocaine

    African Journals Online (AJOL)


    excitation like perioral twitching or tinnitus, seizures in our case. The occurrence of cardiac arrest was within a ten minute period after submucosal infiltration of 6 ml lignocaine 2% (120 mg) and. 1:200,000 epinephrine (30 μg). Further, the rapid onset and offset of symptoms would likely correlate with epinephrine and not ...

  20. Juvenile Arrests, 2007. Juvenile Justice Bulletin (United States)

    Puzzanchera, Charles


    This Bulletin summarizes 2007 juvenile crime and arrest data reported by local law enforcement agencies across the country and cited in the FBI report, "Crime in the United States 2007." The Bulletin describes the extent and nature of juvenile crime that comes to the attention of the justice system. It serves as a baseline for comparison for…

  1. The Organizational Determinants of Police Arrest Decisions (United States)

    Chappell, Allison T.; MacDonald, John M.; Manz, Patrick W.


    A limited amount of research has examined the relationship between characteristics of police organizations and policing styles. In particular, few studies have examined the link between organizational structures and police officer arrest decisions. Wilson's (1968) pioneering case study of police organizations suggested that individual police…

  2. Heart Attack or Sudden Cardiac Arrest: How Are They Different? (United States)

    ... Attack or Sudden Cardiac Arrest: How Are They Different? Updated:Mar 15,2018 People often use these ... The heart attack symptoms in women can be different than men. What is cardiac arrest? Sudden cardiac ...

  3. Reproduction of Lightning Incidence Resulted in Line Surge Arrester Failure (United States)

    Kawamura, Hironao; Kozuka, Masahiro; Itamoto, Naoki; Ishii, Masaru

    There is possibility that lightning strokes to transmission lines with large peaks and/or long duration of currents cause arrester failures. Hence it is important to evaluate reliability of transmission lines considering arrester failures caused by lightning strokes. Actually, arrester failures were caused by a winter lightning stroke to the tower top of one circuit transmission line. In this letter, the lightning stroke associated with the arrester failures is evaluated based on observation of electromagnetic field and analysis by EMTP simulation.

  4. Dynamic crack arrest in ceramics and ceramic composites (United States)

    Kobayashi, A. S.; Yang, K. H.


    The results of past dynamic crack arrest experiments involving structural ceramics and ceramic composites are reviewed and analyzed. The lack of dynamic crack arrest in very brittle materials is discussed and contrasted with dynamic crack arrest in somewhat brittle metallic and polymeric materials. Numerical analyses show that the lack of crack arrest is due to reduced dynamic fracture resistance of the material and is not due to the kinetic energy.

  5. An Audit Of Perioperative Cardiac Arrest At Lagos University ...

    African Journals Online (AJOL)

    Objective: Intraoperative cardiac arrests are not uncommon and are related to both surgical and anaesthetic factors. This study aimed to examine the factors which predispose to a periopeartive cardiac arrest, to assess the appropriateness of therapy and the outcome. Materials and Methods: All perioperative cardiac arrests ...

  6. Pattern of Perioperative Cardiac Arrests at University of Maiduguri ...

    African Journals Online (AJOL)

    only 4 out of the 14 cardiac arrests. Only 2(14%) out of 14 cardiac arrests recovered to home discharge, one of them with significant neurological deficit. Majority of arrests were due to hypoxia from airway problems that were not detected early. There is need to improve on patient monitoring, knowledge of CPR and intensive ...

  7. Transient Central Diabetes Insipidus and Marked Hypernatremia following Cardiorespiratory Arrest


    Koubar, Sahar H.; Younes, Eliane


    Central Diabetes Insipidus is often an overlooked complication of cardiopulmonary arrest and anoxic brain injury. We report a case of transient Central Diabetes Insipidus (CDI) following cardiopulmonary arrest. It developed 4 days after the arrest resulting in polyuria and marked hypernatremia of 199?mM. The latter was exacerbated by replacing the hypotonic urine by isotonic saline.

  8. Transient Central Diabetes Insipidus and Marked Hypernatremia following Cardiorespiratory Arrest

    Directory of Open Access Journals (Sweden)

    Sahar H. Koubar


    Full Text Available Central Diabetes Insipidus is often an overlooked complication of cardiopulmonary arrest and anoxic brain injury. We report a case of transient Central Diabetes Insipidus (CDI following cardiopulmonary arrest. It developed 4 days after the arrest resulting in polyuria and marked hypernatremia of 199 mM. The latter was exacerbated by replacing the hypotonic urine by isotonic saline.

  9. 32 CFR 935.125 - Citation in place of arrest. (United States)


    ... 32 National Defense 6 2010-07-01 2010-07-01 false Citation in place of arrest. 935.125 Section 935... INSULAR REGULATIONS WAKE ISLAND CODE Peace Officers § 935.125 Citation in place of arrest. In any case in which a peace officer may make an arrest without a warrant, he may issue and serve a citation if he...

  10. The cyclin-A CYCA1;2/TAM is required for the meiosis I to meiosis II transition and cooperates with OSD1 for the prophase to first meiotic division transition.

    Directory of Open Access Journals (Sweden)

    Isabelle d'Erfurth


    Full Text Available Meiosis halves the chromosome number because its two divisions follow a single round of DNA replication. This process involves two cell transitions, the transition from prophase to the first meiotic division (meiosis I and the unique meiosis I to meiosis II transition. We show here that the A-type cyclin CYCA1;2/TAM plays a major role in both transitions in Arabidopsis. A series of tam mutants failed to enter meiosis II and thus produced diploid spores and functional diploid gametes. These diploid gametes had a recombined genotype produced through the single meiosis I division. In addition, by combining the tam-2 mutation with AtSpo11-1 and Atrec8, we obtained plants producing diploid gametes through a mitotic-like division that were genetically identical to their parents. Thus tam alleles displayed phenotypes very similar to that of the previously described osd1 mutant. Combining tam and osd1 mutations leads to a failure in the prophase to meiosis I transition during male meiosis and to the production of tetraploid spores and gametes. This suggests that TAM and OSD1 are involved in the control of both meiotic transitions.

  11. [Cardiorespiratory arrest at the age of 30]. (United States)

    Porlier, Magali; Porlier, Ludovic; Lefort, Hugues

    The cardiovascular risk of women is specific and polymorphous. Delays in treatment in women are evident and caused by multiple social and anthropological factors as well as changes to lifestyle habits which are becoming similar to those of men. Young women thereby have a higher risk of sudden death than the rest of the female and general population. A nurse who experienced cardiorespiratory arrest at the age of 30 shares her story. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Dental Calculus Arrest of Dental Caries. (United States)

    Keyes, Paul H; Rams, Thomas E

    An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. These observations further document the potential protective effects of dental calculus mineralization against dental caries.

  13. Dental Calculus Arrest of Dental Caries (United States)

    Keyes, Paul H.; Rams, Thomas E.


    Background An inverse relationship between dental calculus mineralization and dental caries demineralization on teeth has been noted in some studies. Dental calculus may even form superficial layers over existing dental caries and arrest their progression, but this phenomenon has been only rarely documented and infrequently considered in the field of Cariology. To further assess the occurrence of dental calculus arrest of dental caries, this study evaluated a large number of extracted human teeth for the presence and location of dental caries, dental calculus, and dental plaque biofilms. Materials and methods A total of 1,200 teeth were preserved in 10% buffered formal saline, and viewed while moist by a single experienced examiner using a research stereomicroscope at 15-25× magnification. Representative teeth were sectioned and photographed, and their dental plaque biofilms subjected to gram-stain examination with light microscopy at 100× magnification. Results Dental calculus was observed on 1,140 (95%) of the extracted human teeth, and no dental carious lesions were found underlying dental calculus-covered surfaces on 1,139 of these teeth. However, dental calculus arrest of dental caries was found on one (0.54%) of 187 evaluated teeth that presented with unrestored proximal enamel caries. On the distal surface of a maxillary premolar tooth, dental calculus mineralization filled the outer surface cavitation of an incipient dental caries lesion. The dental calculus-covered carious lesion extended only slightly into enamel, and exhibited a brown pigmentation characteristic of inactive or arrested dental caries. In contrast, the tooth's mesial surface, without a superficial layer of dental calculus, had a large carious lesion going through enamel and deep into dentin. Conclusions These observations further document the potential protective effects of dental calculus mineralization against dental caries. PMID:27446993

  14. Sulfur dioxide converter and pollution arrester system

    International Nuclear Information System (INIS)

    Montalvo, V.H.


    A sulphur dioxide converter and pollution arrester system are disclosed which involves the treatment of smoke and/or contaminated air emanating from a combustion area by passage through a zone achieving turbulence into a water spray contained first treating chamber. The turbulence zone, into which an atomized catalyst is introduced, serves to create a longer path for cooling as well as increased centrifugal motion to the solid particles in the contaminated air and also the formation of sulphur trioxide. In other words, the arrangement is such that pollution arresting action is provided in the form of ''slinging'' resulting from tangential directional movement and, when combining with the water spray in the first treating chamber, the ultimate formation of sulphuric acid. Subsequently, the contaminated air, containing amounts of sulphurous and sulphuric acids, passes through a second treating chamber, where airflow throughout the system is occasioned by action at the outlet end, such as the vacuum created by a flue and not by independent mechanical means. The arrangement serves to a twofold purpose, i.e. to minimize or arrest pollution and to convert sulphur dioxide, a component of high sulphur coal, into commercially valuable sulphuric acid

  15. Cardiorespiratory arrest in children (out of hospital). (United States)

    Writer, Hilary


    Cardiorespiratory arrest outside hospital occurs in approximately 1/10,000 children a year in resource-rich countries, with two-thirds of arrests occurring in children under 18 months of age. Approximately 45% of cases have undetermined causes, including sudden infant death syndrome. Of the rest, 20% are caused by trauma, 10% by chronic disease, and 6% by pneumonia. We conducted a systematic review aiming to answer the following clinical question: What are the effects of treatments for non-submersion out-of-hospital cardiorespiratory arrest in children? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 15 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: airway management and ventilation (bag-mask ventilation and intubation), bystander cardiopulmonary resuscitation, direct-current cardiac shock, hypothermia, intravenous sodium bicarbonate, standard dose of intravenous adrenaline (epinephrine), and training parents to perform resuscitation.

  16. Variations in Cardiac Arrest Regionalization in California

    Directory of Open Access Journals (Sweden)

    Mary P. Mercer


    Full Text Available Introduction: The development of cardiac arrest centers and regionalization of systems of care may improve survival of patients with out-of-hospital cardiac arrest (OHCA. This survey of the local EMS agencies (LEMSA in California was intended to determine current practices regarding the treatment and routing of OHCA patients and the extent to which EMS systems have regionalized OHCA care across California. Methods: We surveyed all of the 33 LEMSA in California regarding the treatment and routing of OHCA patients according to the current recommendations for OHCA management. Results: Two counties, representing 29% of the California population, have formally regionalized cardiac arrest care. Twenty of the remaining LEMSA have specific regionalization protocols to direct all OHCA patients with return of spontaneous circulation to designated percutaneous coronary intervention (PCI-capable hospitals, representing another 36% of the population. There is large variation in LEMSA ability to influence inhospital care. Only 14 agencies (36%, representing 44% of the population, have access to hospital outcome data, including survival to hospital discharge and cerebral performance category scores. Conclusion: Regionalized care of OHCA is established in two of 33 California LEMSA, providing access to approximately one-third of California residents. Many other LEMSA direct OHCA patients to PCI-capable hospitals for primary PCI and targeted temperature management, but there is limited regional coordination and system quality improvement. Only one-third of LEMSA have access to hospital data for patient outcomes.

  17. A case of thyroid storm with cardiac arrest

    Directory of Open Access Journals (Sweden)

    Nakashima Y


    Full Text Available Yutaka Nakashima,1 Tsuneaki Kenzaka,2 Masanobu Okayama,3 Eiji Kajii31Department for Support of Rural Medicine, Yamaguchi Grand Medical Center, 2Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, Japan; 3Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, JapanAbstract: A 23-year-old man became unconscious while jogging. He immediately received basic life support from a bystander and was transported to our hospital. On arrival, his spontaneous circulation had returned from a state of ventricular fibrillation and pulseless electrical activity. Following admission, hyperthyroidism led to a suspicion of thyroid storm, which was then diagnosed as a possible cause of the cardiac arrest. Although hyperthyroidism-induced cardiac arrest including ventricular fibrillation is rare, it should be considered when diagnosing the cause of treatable cardiac arrest.Keywords: hyperthyroidism, ventricular fibrillation, treatable cardiac arrest, cardiac arrest, cardiopulmonary arrest

  18. [Identifying children at risk for cardiorespiratory arrest]. (United States)

    Carrillo Alvarez, A; Martínez Gutiérrez, A; Salvat Germán, F


    Cardiorespiratory arrest in children with severe disease does not usually present suddenly or unexpectedly but is often the result of a progressive deterioration of respiratory and/or circulatory function. Before failure of these functions occurs, there is a series of clinical signs that serve as a warning. Health professionals should not only evaluate clinical signs of respiratory and/or circulatory insufficiency but should also be able to identify these warning signs as early as possible, preferably in the compensation phase, given that the possibility that this process can be reversed by therapeutic measures decreases as the process progresses.

  19. [Lethal portal venous gas after cardiopulmonary arrest]. (United States)

    Thomachot, L; Arnal, J M; Vialet, R; Albanèse, J; Martin, C


    We report the case of a 51-year-old patient admitted after a transient cardiorespiratory arrest. The abdominal CT scan revealed the presence of hepatic portal venous gas. At laparotomy, a diffuse mesenteric ischaemia was diagnosed. The patient died from multiple organ failure in the subsequent hours. Necrotic bowel is associated with hepatic portal venous gas in 50% of the cases and the current mortality rate is 85%. Gas originates either through intestinal transmucosal passage, either by intraportal bacterial gas production, or through both mechanisms.

  20. Sublingual Microcirculation is Impaired in Post-cardiac Arrest Patients

    DEFF Research Database (Denmark)

    G. Omar, Yasser; Massey, Michael; Wiuff Andersen, Lars


    the microcirculation flow index (MFI) at 6 and 24h in the cardiac arrest patients, and within 6h of emergency department admission in the sepsis and control patients. RESULTS: We evaluated 30 post-cardiac arrest patients, 16 severe sepsis/septic shock patients, and 9 healthy control patients. Sublingual...... markers in the post-cardiac arrest state. METHODS: We prospectively evaluated the sublingual microcirculation in post-cardiac arrest patients, severe sepsis/septic shock patients, and healthy control patients using Sidestream Darkfield microscopy. Microcirculatory flow was assessed using...

  1. The ethics of cardiac arrest research. (United States)

    Miller, B L


    In cardiac arrest research, prior informed consent is not available to resolve the conflict between the rights and well-being of subjects and the possible benefit to future patients. The right to autonomy is the fundamental right that is protected by the legal doctrine of informed consent. As a fundamental right, it cannot be balanced against other goods. Rather, it is a constraint, or trump, on the balancing of goods and can be overridden only for a narrow range of reasons: its recognition in a given case conflicts with another basic right, infringing the right will prevent great harm to others, and excluding a particular case from its scope will recognize and advance the right in the long run. Proxy consent, deferred consent, and presumed consent to cardiac arrest research are examined to determine if they qualify as justified infringements of the right to autonomy. The conclusion is that only presumed consent can be used, provided that the researcher can honestly say that outside of the randomized clinical trial of two or more treatments, a physician would have no basis for choosing one over the others.

  2. Cardiac arrest caused by nafamostat mesilate

    Directory of Open Access Journals (Sweden)

    Hyo Shik Kim


    Full Text Available A 65-year-old man was transferred from the Department of Vascular Surgery to Nephrology because of cardiac arrest during hemodialysis. He underwent incision and drainage for treatment of a buttock abscess. Nafamostat mesilate was used as an anticoagulant for hemodialysis to address bleeding from the incision and drainage site. Sudden cardiac arrest occurred after 15 minutes of dialysis. The patient was treated in the intensive care unit for 5 days. Continuous veno-venous hemodiafiltration was started without any anticoagulant in the intensive care unit. Conventional hemodialysis was reinitiated, and nafamostat mesilate was used again because of a small amount of continued bleeding. Ten minutes after hemodialysis, the patient complained of anaphylactic signs and symptoms such as dyspnea, hypotension, and facial swelling. Epinephrine, dexamethasone, and pheniramin were injected under the suspicion of anaphylactic shock, and the patient recovered. Total immunoglobulin E titer was high, and skin prick test revealed weak positivity for nafamostat mesilate. We first report a case of anaphylactic shock caused by nafamostat mesilate in Korea.

  3. Out-of-Hospital Cardiac Arrest in Denmark

    DEFF Research Database (Denmark)

    Wissenberg Jørgensen, Mads

    challenges, due to the victim’s physical location, which brings an inherent risk of delay (or altogether absence) of recognition and treatment of cardiac arrest. A low frequency of bystander cardiopulmonary resuscitation and low 30-day survival after out-of-hospital cardiac arrest were identified nearly ten...

  4. Cardiac arrest during anesthesia at a University Hospital in Nigeria

    African Journals Online (AJOL)


    Mar 7, 2013 ... Background: We assessed the incidence and outcomes of cardiac arrest during anesthesia in the operating room at our university hospital. A previous study on intraoperative cardiac arrests covered a period from 1994-1998 and since then; anesthetic personnel, equipment, and workload have increased ...

  5. Cardiac arrest during anesthesia at a University Hospital in Nigeria ...

    African Journals Online (AJOL)

    Background: We assessed the incidence and outcomes of cardiac arrest during anesthesia in the operating room at our university hospital. A previous study on intraoperative cardiac arrests covered a period from 1994-1998 and since then; anesthetic personnel, equipment, and workload have increased remarkably.

  6. Efficacy of silver diamine fluoride for Arresting Caries Treatment.

    NARCIS (Netherlands)

    Yee, R.T.F.; Holmgren, C.J.; Mulder, J.; Lama, D.; Walker, D.; Palenstein Helderman, W.H. van


    Arresting Caries Treatment (ACT) has been proposed to manage untreated dental caries in children. This prospective randomized clinical trial investigated the caries-arresting effectiveness of a single spot application of: (1) 38% silver diamine fluoride (SDF) with tannic acid as a reducing agent;

  7. A novel parameter estimation method for metal oxide surge arrester ...

    Indian Academy of Sciences (India)

    45 and 60μs, is 2–4% lower than that of a 8μs current impulse (Martinez & Durbak 2005). In order to reproduce the MO surge arrester dynamic characteristics mentioned previously, a lot of researches have been done on modelling and simulation of MO surge arresters (Martinez. & Durbak 2005). A dynamic model has been ...

  8. A novel parameter estimation method for metal oxide surge arrester ...

    Indian Academy of Sciences (India)

    Accurate modelling and exact determination of Metal Oxide (MO) surge arrester parameters are very important for arrester allocation, insulation coordination studies and systems reliability calculations. In this paper, a new technique, which is the combination of Adaptive Particle Swarm Optimization (APSO) and Ant Colony ...

  9. A novel parameter estimation method for metal oxide surge arrester ...

    Indian Academy of Sciences (India)

    with experimental results. Keywords. Metal oxide surge arrester models; PSO; ACO; parameter estimation;. EMTP. 1. Introduction. Metal oxide (MO) surge arresters are widely used as protective devices against switching and lightning over-voltages in power systems. The proper nonlinear voltage-current characteristics,. ∗.

  10. The Influence of Mandatory Arrest Policies, Police Organizational Characteristics, and Situational Variables on the Probability of Arrest in Domestic Violence Cases (United States)

    Eitle, David


    Prior research into factors predicting arrest in domestic violence cases is limited in three regards: (a) no examination of whether mandatory arrest policies are associated with increased risk of arrest across multiple jurisdictions; (b) little consideration of whether police organizational characteristics influence arrest in such cases; and (c)…

  11. Location of cardiac arrest and impact of pre-arrest chronic disease and medication use on survival. (United States)

    Granfeldt, Asger; Wissenberg, Mads; Hansen, Steen Møller; Lippert, Freddy K; Torp-Pedersen, Christian; Christensen, Erika Frischknecht; Christiansen, Christian Fynbo


    Cardiac arrest in a private location is associated with a higher mortality when compared to public location. Past studies have not accounted for pre-arrest factors such as chronic disease and medication. To investigate whether the association between cardiac arrest in a private location and a higher mortality can be explained by differences in chronic diseases and medication. We identified 27,771 out-of-hospital cardiac arrest patients ≥18 years old from the Danish Cardiac Arrest Registry (2001-2012). Using National Registries, we identified pre-arrest chronic disease and medication. To investigate the importance of cardiac arrest related factors and chronic disease and medication use we performed adjusted Cox regression analyses during day 0-7 and day 8-365 following cardiac arrest to calculate hazard ratios (HR) for death. Day 0-7: Un-adjusted HR for death day 0-7 was 1.21 (95%CI:1.18-1.25) in private compared to public location. When including cardiac arrest related factors HR for death was 1.09 (95%CI:1.06-1.12). Adding chronic disease and medication to the analysis changed HR for death to 1.08 (95%CI:1.05-1.12). 8-365 day: The un-adjusted HR for death day 8-365 was 1.70 (95% CI: 1.43-2.02) in private compared to public location. When including cardiac arrest related factors the HR decreased to 1.39 (95% CI: 1.14-1.68). Adding chronic disease and medication to the analysis changed HR for death to 1.27 (95% CI:1.04-1.54). The higher mortality following cardiac arrest in a private location is partly explained by a higher prevalence of chronic disease and medication use in patients surviving until day 8. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Structural arrest in an ideal gas. (United States)

    van Ketel, Willem; Das, Chinmay; Frenkel, Daan


    We report a molecular dynamics study of a simple model system that has the static properties of an ideal gas, yet exhibits nontrivial "glassy" dynamics behavior at high densities. The constituent molecules of this system are constructs of three infinitely thin hard rods of length L, rigidly joined at their midpoints. The crosses have random but fixed orientation. The static properties of this system are those of an ideal gas, and its collision frequency can be computed analytically. For number densities NL(3)/V>1, the single-particle diffusivity goes to zero. As the system is completely structureless, standard mode-coupling theory cannot describe the observed structural arrest. Nevertheless, the system exhibits many dynamical features that appear to be mode-coupling-like. All high-density incoherent intermediate scattering functions collapse onto master curves that depend only on the wave vector.

  13. Crack arrest tests for a new ASTM-standard

    International Nuclear Information System (INIS)

    Gillot, R.; Kalthoff, J.


    In order to quantitatively describe the procedures in crack arrest, the following two parameters must be known which can be determined either experimentally or analytically: 1. The crack arrest toughness which represents a measure of the capability of the material to stop running cracks and 2. the stress intensity factor at the peak of the crack of the running or stopping crack as a measure of the danger of the crack. As cracks propagate as long as the K factor is greater than the crack arrest toughness, there are principally two possibilities of influencing the arrest: either one makes sure that the crack is led into an increasingly tougher region, i.e. by material-specific measures, or by leading the crack into an area of reduced stress by constructive measures. Both possibilities for crack arrest are described by the same fracture mechanical formula. (orig./RW) [de

  14. Maturation arrest of human oocytes at germinal vesicle stage (United States)

    Chen, Zhi Qin; Ming, Teng Xiao; Nielsen, Hans Ingolf


    Maturation arrest of human oocytes may occur at various stages of the cell cycle. A total failure of human oocytes to complete meiosis is rarely observed during assisted conception cycles. We describe here a case of infertile couples for whom all oocytes repeatedly failed to mature at germinal vesicle (GV) stage during in vitro fertilization/Intra cytoplasmic sperm injection (IVF/ICSI). The patient underwent controlled ovarian stimulation followed by oocyte retrieval and IVF/ICSI. The oocytes were stripped off cumulus cells prior to the ICSI procedure and their maturity status was defined. The oocyte maturation was repeatedly arrested at the GV. Oocyte maturation arrest may be the cause of infertility in this couple. The recognition of oocyte maturation arrest as a specific medical condition may contribute to the characterization of the currently known as “oocyte factor.” The cellular and genetic mechanisms causing oocyte maturation arrest should be the subject for further investigation. PMID:21234179

  15. ERC initiatives to reduce the burden of cardiac arrest: the European Cardiac Arrest Awareness Day. (United States)

    Georgiou, Marios; Lockey, Andrew S


    The rate of survival from out-of-hospital cardiac arrest in Europe remains unacceptably low and could be increased by better bystander cardiopulmonary resuscitation (CPR) rates. The European Resuscitation Council has announced that there will be a European Cardiac Arrest Awareness Day every year on the 16th of October. This is to coincide with the goals of the Written Declaration passed by the European Parliament in June 2012 that emphasised the importance of equal access to CPR and automated external defibrillator (AED) training. The topic of this year's Awareness Day is 'Children Saving Lives' and it is hoped that all national resuscitation councils will promote awareness of the benefits of training all children in CPR and AED use and lobby for legislative change to ensure that all children receive this training. Children are not just the adults of tomorrow - they are the lifesavers of today and tomorrow. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Multicenter Cohort Study of In-Hospital Pediatric Cardiac Arrest (United States)

    Meert, Kathleen L.; Donaldson, Amy; Nadkarni, Vinay; Tieves, Kelly S.; Schleien, Charles L.; Brilli, Richard J.; Clark, Robert S. B.; Shaffner, D. H.; Levy, Fiona; Statler, Kimberly; Dalton, H.J.; van der Jagt, Elise W.; Hackbarth, Richard; Pretzlaff, Robert; Hernan, Lynn; Dean, J. Michael; Moler, Frank W.


    Objectives (1) Describe the clinical characteristics, hospital courses and outcomes of a cohort of children cared for within the Pediatric Emergency Care Applied Research Network (PECARN) who experienced in-hospital cardiac arrest with sustained return of circulation between July 1, 2003 and December 31, 2004, and (2) identify factors associated with hospital mortality in this population. These data are required to prepare a randomized trial of therapeutic hypothermia on neurobehavioral outcomes in children after in-hospital cardiac arrest. Design Retrospective cohort study. Setting Fifteen children’s hospitals associated with PECARN. Patients Patients between one day and 18 years of age who had cardiopulmonary resuscitation (CPR) and received chest compressions for >1 minute, and had a return of circulation for >20 minutes. Interventions None. Measurements and Main Results A total of 353 patients met entry criteria; 172 (48.7%) survived to hospital discharge. Among survivors, 132 (76.7%) had good neurological outcome documented by Pediatric Cerebral Performance Category scores. After adjustment for age, gender and first documented cardiac arrest rhythm, variables available prior to and during the arrest that were independently associated with increased mortality included pre-existing hematologic, oncologic, or immunologic disorders, genetic or metabolic disorders, presence of an endotracheal tube prior to the arrest, and the use of sodium bicarbonate during the arrest. Variables associated with decreased mortality included post-operative CPR. Extending the time frame to include variables available prior to, during, and within 12 hours following arrest, variables independently associated with increased mortality included the use of calcium during the arrest. Variables associated with decreased mortality included higher minimum blood pH and pupillary responsiveness. Conclusions Many factors are associated with hospital mortality among children after in

  17. Experimental investigation of interfacial crack arrest in sandwich beams subjected to fatigue loading using a novel crack arresting device

    DEFF Research Database (Denmark)

    Martakos, G.; Andreasen, J.H.; Berggreen, Christian


    A recently proposed face-sheet–core interface crack arresting device is implemented in sandwich beams and tested using the Sandwich Tear Test configuration. Fatigue loading conditions are applied to propagate the crack and determine the effect of the crack stopper on the fatigue growth rate...... the energy release rate, mode mixity and to simulate crack propagation and arrest of the crack. Finally, the effectiveness of the crack arresting device is demonstrated on composite sandwich beams subjected to fatigue loading conditions....... and arrest of the crack. Digital image correlation is used through the duration of the fatigue experiment to track the strain evolution as the crack tip advances. The measured strains are related to crack tip propagation, arrest, and re-initiation of the crack. A finite element model is used to calculate...

  18. Sudden Cardiac Arrest during Participation in Competitive Sports. (United States)

    Landry, Cameron H; Allan, Katherine S; Connelly, Kim A; Cunningham, Kris; Morrison, Laurie J; Dorian, Paul


    The incidence of sudden cardiac arrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiac arrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiac arrests that occurred during participation in sports activities within a specific region of Canada and to determine their causes. In this retrospective study, we used the Rescu Epistry cardiac arrest database (which contains records of every cardiac arrest attended by paramedics in the network region) to identify all out-of-hospital cardiac arrests that occurred from 2009 through 2014 in persons 12 to 45 years of age during participation in a sport. Cases were adjudicated as sudden cardiac arrest (i.e., having a cardiac cause) or as an event resulting from a noncardiac cause, on the basis of records from multiple sources, including ambulance call reports, autopsy reports, in-hospital data, and records of direct interviews with patients or family members. Over the course of 18.5 million person-years of observation, 74 sudden cardiac arrests occurred during participation in a sport; of these, 16 occurred during competitive sports and 58 occurred during noncompetitive sports. The incidence of sudden cardiac arrest during competitive sports was 0.76 cases per 100,000 athlete-years, with 43.8% of the athletes surviving until they were discharged from the hospital. Among the competitive athletes, two deaths were attributed to hypertrophic cardiomyopathy and none to arrhythmogenic right ventricular cardiomyopathy. Three cases of sudden cardiac arrest that occurred during participation in competitive sports were determined to have been potentially identifiable if the athletes had undergone preparticipation screening. In our study involving persons who had out-of-hospital cardiac arrest, the incidence of sudden cardiac

  19. Outcomes following military traumatic cardiorespiratory arrest: A prospective observational study. (United States)

    Tarmey, Nicholas T; Park, Claire L; Bartels, Oliver J; Konig, Thomas C; Mahoney, Peter F; Mellor, Adrian J


    To determine the characteristics of military traumatic cardiorespiratory arrest (TCRA), and to identify factors associated with successful resuscitation. Data was collected prospectively for adult casualties suffering TCRA presenting to a military field hospital in Helmand Province, Afghanistan between 29 November 2009 and 13 June 2010. Data was available for 52 patients meeting the inclusion criteria. The mean age (range) was 25 (18-36) years. The principal mechanism of injury was improvised explosive device (IED) explosion, the lower limbs were the most common sites of injury and exsanguination was the most common cause of arrest. Fourteen (27%) patients exhibited ROSC and four (8%) survived to discharge. All survivors achieved a good neurological recovery by Glasgow Outcome Scale. Three survivors had arrested due to exsanguination and one had arrested due to pericardial tamponade. All survivors had arrested after commencing transport to hospital and the longest duration of arrest associated with survival was 24 min. All survivors demonstrated PEA rhythms on ECG during arrest. When performed, 6/24 patients had ultrasound evidence of cardiac activity during arrest; all six with cardiac activity subsequently exhibited ROSC and two survived to hospital discharge. Overall rates of survival from military TCRA were similar to published civilian data, despite military TCRA victims presenting with high Injury Severity Scores and exsanguination due to blast and fragmentation injuries. Factors associated with successful resuscitation included arrest beginning after transport to hospital, the presence of electrical activity on ECG, and the presence of cardiac movement on ultrasound examination. Crown Copyright © 2011. Published by Elsevier Ireland Ltd. All rights reserved.

  20. Epidemiology and management of cardiac arrest: what registries are revealing. (United States)

    Gräsner, Jan-Thorsten; Bossaert, Leo


    Major European institutions report cardiovascular disease (CVD) as the first cause of death in adults, with cardiac arrest and sudden death due to coronary ischaemia as the primary single cause. Global incidence of CVD is decreasing in most European countries, due to prevention, lifestyle and treatment. Mortality of acute coronary events inside the hospital decreases more rapidly than outside the hospital. To improve the mortality of cardiac arrest outside the hospital, reliable epidemiological and process figures are essential: "we can only manage what we can measure". Europe is a patchwork of 47 countries (total population of 830 million), with a 10-fold difference in incidence of coronary heart disease between North and South, East and West, and a 5-fold difference in number of EMS-treated cardiac arrest (range 17-53/1000,000/year). Epidemiology of cardiac arrest should not be calculated as a European average, but it is appropriate to describe the incidence of cardiac arrest, the resuscitation process, and the outcome in each of the European regions, for benchmarking and quality management. Epidemiological reports of cardiac arrest should specify definitions, nominator (number of cases) and denominator (study population). Recently some regional registries in North America, Japan and Europe fulfilled these conditions. The European Registry of Cardiac Arrest (EuReCa) has the potential to achieve these objectives on a pan-European scale. For operational applications, the Utstein definition of "Cardiac arrest" is used which includes the potential of survival. For application in community health, the WHO definition of "sudden death" is frequently used, describing the mode of death. There is considerable overlap between both definitions. But this explains that no single method can provide all information. Integrating data from multiple sources (local, national, multinational registries and surveys, death certificates, post-mortem reports, community statistics, medical

  1. Post-resuscitation care for survivors of cardiac arrest

    Directory of Open Access Journals (Sweden)

    Ashvarya Mangla


    Full Text Available Cardiac arrest can occur following a myriad of clinical conditions. With advancement of medical science and improvements in Emergency Medical Services systems, the rate of return of spontaneous circulation for patients who suffer an out-of-hospital cardiac arrest (OHCA continues to increase. Managing these patients is challenging and requires a structured approach including stabilization of cardiopulmonary status, early consideration of neuroprotective strategies, identifying and managing the etiology of arrest and initiating treatment to prevent recurrence. This requires a closely coordinated multidisciplinary team effort. In this article, we will review the initial management of survivors of OHCA, highlighting advances and ongoing controversies.

  2. Arresting dissolution by interfacial rheology design (United States)

    Beltramo, Peter J.; Gupta, Manish; Alicke, Alexandra; Liascukiene, Irma; Gunes, Deniz Z.; Baroud, Charles N.


    A strategy to halt dissolution of particle-coated air bubbles in water based on interfacial rheology design is presented. Whereas previously a dense monolayer was believed to be required for such an “armored bubble” to resist dissolution, in fact engineering a 2D yield stress interface suffices to achieve such performance at submonolayer particle coverages. We use a suite of interfacial rheology techniques to characterize spherical and ellipsoidal particles at an air–water interface as a function of surface coverage. Bubbles with varying particle coverages are made and their resistance to dissolution evaluated using a microfluidic technique. Whereas a bare bubble only has a single pressure at which a given radius is stable, we find a range of pressures over which bubble dissolution is arrested for armored bubbles. The link between interfacial rheology and macroscopic dissolution of ∼ 100 μm bubbles coated with ∼ 1 μm particles is presented and discussed. The generic design rationale is confirmed by using nonspherical particles, which develop significant yield stress at even lower surface coverages. Hence, it can be applied to successfully inhibit Ostwald ripening in a multitude of foam and emulsion applications. PMID:28893993

  3. MRI in the assessment of growth arrest

    Energy Technology Data Exchange (ETDEWEB)

    Lohman, Martina; Kivisaari, Arto; Kivisaari, Leena [Helsinki Univ. Central Hospital (Finland). Dept. of Radiology; Vehmas, Tapio [Finnish Institute of Occupational Health, Helsinki (Finland); Kallio, Pentti; Puntila, Juha [Department of Paediatric Surgery, Hospital for Children and Adolescents, University Central Hospital, Helsinki (Finland)


    Objective: To compare MRI with X-ray tomography in the assessment of bone bridges across the growth plate. Materials and methods: The investigation consisted of two parts. (1) Eleven children with 13 epiphyses suspected of physeal growth arrests were examined with conventional X-ray tomography and MRI. The bar was post-traumatic in eight children, postinfectious in two and due to a congenital, operated pes equinovarus in one. Three blinded radiologists separately evaluated the examinations retrospectively. (2) The images of four children with known physeal bars in the ankle were mixed with 36 normal examinations obtained 1-year after trauma and evaluated blindly by three radiologists. Results: In 5 of 13 epiphysis, the bony bridge was considered smaller on MRI than on X-ray tomography, in 7 of 13 it was considered equal, while it was larger only in one. The interobserver agreement (weighted kappa) was 0.8 (very good) for MRI, 0.76 (good) for X-ray tomography and 0.60 (moderate) for radiographs. The four bony bridges were easily detected on MRI. Conclusions: Compared to MRI, the size of bridges was estimated larger by tomography in about half of the patients. (orig.)

  4. Cardiac Arrest in Pediatric Patients Receiving Azithromycin. (United States)

    Valdés, Santiago O; Kim, Jeffrey J; Niu, Mary C; de la Uz, Caridad M; Miyake, Christina Y; Moffett, Brady S


    To compare outcomes of pediatric patients treated with azithromycin compared with penicillin or cephalosporin. We hypothesized that azithromycin use would not be associated with increased cardiac mortality in the pediatric population. Retrospective cohort study from the Pediatric Health Information System database between 2008 and 2012. Patients Azithromycin was used in 5039 (6.1%); penicillin or cephalosporin was used in 77 943 (93.9%). Overall prevalence of antibiotic-associated CPR was 0.14%. Patients receiving a macrolide antibiotic had a lower prevalence of CPR compared with patients receiving a penicillin or cephalosporin (0.04% vs 0.14%, P = .04), and there was no difference in mortality. Multivariable analysis did not find an association between macrolide use and CPR. In contrast to recent adult studies, among children hospitalized for community-acquired pneumonia, azithromycin use was not associated with a greater prevalence of cardiac arrest compared with penicillin or cephalosporin use. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Effects of viscosity on cerebral blood flow after cardiac arrest

    NARCIS (Netherlands)

    Bisschops, L.L.A.; Pop, G.A.M.; Teerenstra, S.; Struijk, P.C.; Hoeven, J.G. van der; Hoedemaekers, C.W.E.


    OBJECTIVES: To determine blood viscosity in adult comatose patients treated with mild therapeutic hypothermia after cardiac arrest and to assess the relation between blood viscosity, cerebral blood flow, and cerebral oxygen extraction. DESIGN: Observational study. SETTING: Tertiary care university

  6. Therapeutic hypothermia in the treatment of cardiorespiratory arrest. (United States)

    Fenwick, Rob


    Prompt treatment of patients with cardiorespiratory arrest can mean the difference between life and death. This article analyses the use of therapeutic hypothermia and aims to educate practitioners about its advantages and disadvantages as an immediate treatment.

  7. Endothelial Dysfunction in Resuscitated Cardiac Arrest (ENDO-RCA)

    DEFF Research Database (Denmark)

    Meyer, Anna Sina P; Ostrowski, Sisse Rye; Kjærgaard, Jesper


    BACKGROUND: Morbidity and mortality following initial survival of cardiac arrest remain high despite great efforts to improve resuscitation techniques and post-resuscitation care, in part due to the ischemia-reperfusion injury secondary to the restoration of the blood circulation. Patients...... resuscitated from cardiac arrest display evidence of endothelial injury and coagulopathy (hypocoagulability, hyperfibrinolysis), which in associated with poor outcome. Recent randomized controlled trials have revealed that treatment with infusion of prostacyclin reduces endothelial damage after major surgery...... and AMI. Thus, a study is pertinent to investigate if prostacyclin infusion as a therapeutic intervention reduces endothelial damage without compromising, or even improving, the hemostatic competence in resuscitated cardiac arrest patients. Post-cardiac arrest patients frequently have a need...

  8. Arrest of cytoplasmic streaming induces algal proliferation in green paramecia.

    Directory of Open Access Journals (Sweden)

    Toshiyuki Takahashi

    Full Text Available A green ciliate Paramecium bursaria, bearing several hundreds of endosymbiotic algae, demonstrates rotational microtubule-based cytoplasmic streaming, in which cytoplasmic granules and endosymbiotic algae flow in a constant direction. However, its physiological significance is still unknown. We investigated physiological roles of cytoplasmic streaming in P. bursaria through host cell cycle using video-microscopy. Here, we found that cytoplasmic streaming was arrested in dividing green paramecia and the endosymbiotic algae proliferated only during the arrest of cytoplasmic streaming. Interestingly, arrest of cytoplasmic streaming with pressure or a microtubule drug also induced proliferation of endosymbiotic algae independently of host cell cycle. Thus, cytoplasmic streaming may control the algal proliferation in P. bursaria. Furthermore, confocal microscopic observation revealed that a division septum was formed in the constricted area of a dividing paramecium, producing arrest of cytoplasmic streaming. This is a first report to suggest that cytoplasmic streaming controls proliferation of eukaryotic cells.

  9. Early myoclonic status and outcome after cardiorespiratory arrest


    Morris, H; Howard, R; Brown, P


    It has been suggested that early myoclonic status after cardiorespiratory arrest is an agonal event.1 Here we describe three cases who developed early myoclonic status during a coma after cardiorespiratory arrest due to acute asthma. As consciousness improved, each patient developed Lance-Adams type multifocal myoclonus, but the eventual outcome was satisfactory. Only one patient needed assistance to walk, and all three were self caring. One patient had persistent dyscalc...

  10. Dynamic propagation and cleavage crack arrest in bainitic steel

    International Nuclear Information System (INIS)

    Hajjaj, M.


    In complement of the studies of harmfulness of defects, generally realized in term of initiation, the concept of crack arrest could be used as complementary analyses to the studies of safety. The stop occurs when the stress intensity factor becomes lower than crack arrest toughness (KIa) calculated in elasto-statics (KI ≤ KIa). The aim of this thesis is to understand and predict the stop of a crack propagating at high speed in a 18MND5 steel used in the pressure water reactor (PWR). The test chosen to study crack arrest is the disc thermal shock test. The observations under the scanning electron microscope of the fracture surface showed that the crack arrest always occurs in cleavage mode and that the critical microstructural entity with respect to the propagation and crack arrest corresponds to at least the size of the prior austenitic grain. The numerical analyses in elasto-statics confirm the conservatism of the codified curve of the RCC-M with respect to the values of KIa. The dynamic numerical analyses show that the deceleration of the crack measured at the end of the propagation is related to the global dynamic of the structure (vibrations). The transferability to components of crack arrest toughness obtained from tests analysed in static is thus not assured. The disc thermal shock tests were also modelled by considering a criterion of propagation and arrest of the type 'RKR' characterized by a critical stress sc which depends on the temperature. The results obtained account well for the crack jump measured in experiments as well as the shape of the crack arrest front. (author)

  11. Al-Qaeda arrest casts shadow over the LHC

    CERN Document Server

    Dacey, James


    "Cern remains on course for the imminent switch-on of the Large Hadron Collider (LHC) despite the media frenzy following the recent arrest of a physicist who had been working at the facility. The researcher in question is a 32-year-old man of Algerian descent who is expected to face trail in France - the country in which he was arrested" (0.5 page)

  12. Structural basis of RNA polymerase II backtracking, arrest and reactivation. (United States)

    Cheung, Alan C M; Cramer, Patrick


    During gene transcription, RNA polymerase (Pol) II moves forwards along DNA and synthesizes messenger RNA. However, at certain DNA sequences, Pol II moves backwards, and such backtracking can arrest transcription. Arrested Pol II is reactivated by transcription factor IIS (TFIIS), which induces RNA cleavage that is required for cell viability. Pol II arrest and reactivation are involved in transcription through nucleosomes and in promoter-proximal gene regulation. Here we present X-ray structures at 3.3 Å resolution of an arrested Saccharomyces cerevisiae Pol II complex with DNA and RNA, and of a reactivation intermediate that additionally contains TFIIS. In the arrested complex, eight nucleotides of backtracked RNA bind a conserved 'backtrack site' in the Pol II pore and funnel, trapping the active centre trigger loop and inhibiting mRNA elongation. In the reactivation intermediate, TFIIS locks the trigger loop away from backtracked RNA, displaces RNA from the backtrack site, and complements the polymerase active site with a basic and two acidic residues that may catalyse proton transfers during RNA cleavage. The active site is demarcated from the backtrack site by a 'gating tyrosine' residue that probably delimits backtracking. These results establish the structural basis of Pol II backtracking, arrest and reactivation, and provide a framework for analysing gene regulation during transcription elongation.

  13. Outcome of out-of-hospital cardiorespiratory arrest in children. (United States)

    López-Herce, Jesús; García, Cristina; Domínguez, Pedro; Rodríguez-Núñez, Antonio; Carrillo, Angel; Calvo, Custodio; Delgado, Miguel Angel


    To analyze the characteristics and outcome of out-of-hospital cardiorespiratory arrest in children in Spain. Secondary analysis of data from a prospective, multicenter study analyzing cardiorespiratory arrest in children. Ninety-five children between 7 days and 16 years with cardiorespiratory arrest. Data were recorded according to the Utstein style. The outcome variables were the sustained return of spontaneous circulation (initial survival), and survival at 1 year (final survival). Neurologic and general performance outcome was assessed by the Pediatric Cerebral Performance Category (PCPC) scale and the Pediatric Overall Performance Category (POPC) scale. Initial survival was 47.3% and 1-year survival was 26.4%. Mortality was higher in children younger than 1 year. Survival of patients with respiratory arrest (82.1%) was significantly higher than survival of cardiac arrest victims (14.4%). Patients who were initially resuscitated by laypersons or paramedics had higher survival (53.6%) than those who were initially resuscitated by doctors and/or nurses (15.2%) (P cardiorespiratory arrest in children is high. When resuscitation is started soon by layperson or paramedics, survival is increased. Duration of resuscitation efforts is the best indicator of mortality. Most of survivors had good long-term neurologic outcome.

  14. Respiratory Arrest in an Obese Pregnant Woman with Hyperemesis Gravidarum

    Directory of Open Access Journals (Sweden)

    Ayumi Iwashita


    Full Text Available A pregnant, non-Japanese-speaking Peruvian, and, thus, with communication difficulty, suffered hyperemesis gravidarum and had respiratory arrest, requiring cardiopulmonary resuscitation. The obese pregnant woman (prepregnancy weight: 107 kg had vomited and lost 15 kg in bodyweight over appropriately 2 weeks prior to the arrest but had not complained due to communication difficulty, which, together with her obesity, prevented a Japanese obstetrician from noticing her severe condition. 1,000 mL of low potassium fluid plus thiamine was administered. She became unable to stand, suggesting lower-extremity-proximal-muscle weakness, and then respiratory arrest occurred. Hypopotassemia (2.3 mEq/L, pulseless electrical activity, and muscle weakness suggested the presence of severe potassium deficiency, which may have caused respiratory muscle paralysis, leading to the respiratory arrest. Hypercapnea was severer than expected for compensatory hypoventilation, indicating the presence of concomitant severe hypoventilation, which may also have contributed to respiratory arrest. She recovered with electrolyte and volume replacement. Respiratory arrest can occur with hyperemesis gravidarum, and obesity and communication difficulties can prevent the early detection of severe conditions.

  15. Cardiac arrest due to lymphocytic colitis: a case report

    Directory of Open Access Journals (Sweden)

    Groth Kristian A


    Full Text Available Abstract Introduction We present a case of cardiac arrest due to hypokalemia caused by lymphocytic colitis. Case presentation A 69-year-old Caucasian man presented four months prior to a cardiac arrest with watery diarrhea and was diagnosed with lymphocytic colitis. Our patient experienced a witnessed cardiac arrest at his general practitioner's surgery. Two physicians and the emergency medical services resuscitated our patient for one hour and four minutes before arriving at our university hospital. Our patient was defibrillated 16 times due to the recurrence of ventricular tachyarrhythmias. An arterial blood sample revealed a potassium level of 2.0 mmol/L (reference range: 3.5 to 4.6 mmol/L and pH 6.86 (reference range: pH 7.37 to 7.45. As the potassium level was corrected, the propensity for ventricular tachyarrhythmias ceased. Our patient recovered from his cardiac arrest without any neurological deficit. Further tests and examinations revealed no other reason for the cardiac arrest. Conclusion Diarrhea can cause life-threatening situations due to the excretion of potassium, ultimately causing cardiac arrest due to hypokalemia. Physicians treating patients with severe diarrhea should consider monitoring their electrolyte levels.

  16. The Lightning Performance of Overhead Distribution Line Installed Mov and Clah Surge Arresters (United States)

    Thanasaksiri, T.


    This paper compares the lightning performance of overhead distribution line which installed two arrester types, metal oxide varistor (MOV) and current limiting arcing horn (CLAH). The performance of line which related to the insulator flashover, with and without arresters installed, has been modeled and analyzed using EMTP. The MOV arrester type gives better line lightning performance. The relatively wide arrester spacings will reduce the lightning performance. The arrester leads should be kept as short as possible.

  17. Cranial computed tomography in the resuscitated patient with cardiac arrest. (United States)

    Naples, Robin; Ellison, Elizabeth; Brady, William J


    The incidence of out-of-hospital and in-hospital cardiorespiratory arrest from all causes in the United States occurs not infrequently. Postresuscitation care should include the identification of the inciting arrest event as well as therapy tailored to support the patient and treat the primary cause of the decompensation. The application of one particular testing modality, cranial computed tomography (CT) of the head, has not yet been determined. We undertook an evaluation of the use of head CT in patients who were resuscitated from cardiac arrest. Prehospital (emergency medical services), ED, and hospital records were reviewed for patients of all ages with cardiorespiratory arrest over a 4-year period (July 1996-June 2000). Information regarding diagnosis, management, and outcome was recorded. The results of cranial CT, if performed, and any apparent resulting therapeutic changes were recorded. Patients with a known traumatic mechanism for the cardiorespiratory arrest were excluded. A total of 454 patients (mean age 58.3 years with 60% male) with cardiorespiratory arrest were entered in the study with 98 (22%) individuals (mean age 58.5 years with 53% male) undergoing cranial CT. Arrest location was as follows: emergency medical services, 41 (42%); ED, 11 (11%); and hospital, 46 (47%). Seventy-eight (79%) patients demonstrated 111 CT abnormalities: edema, 35 (32%); atrophy, 24 (22%); extra-axial hemorrhage, 14 (13%); old infarct, 12 (11%); new infarct, 11 (10%); intraparenchymal hemorrhage, 6 (5%); skull fracture, 5 (4%); mass, 3 (2%); and foreign body, 1 (1%). Therapeutic and diagnostic alterations in care were made in 38 (39%) patients-35 abnormal and 3 normal CTs. The following alterations occurred: medication administration, 26; withdrawal of life support, 7; additional diagnostic study, 6; neurologic consultation, 6; and intracranial pressure monitoring. 4. No patient survived to discharge. In this subset of resuscitated patients with cardiac arrest

  18. Visualizing Vpr-induced G2 arrest and apoptosis.

    Directory of Open Access Journals (Sweden)

    Tomoyuki Murakami

    Full Text Available Vpr is an accessory protein of human immunodeficiency virus type 1 (HIV-1 with multiple functions. The induction of G2 arrest by Vpr plays a particularly important role in efficient viral replication because the transcriptional activity of the HIV-1 long terminal repeat is most active in G2 phase. The regulation of apoptosis by Vpr is also important for immune suppression and pathogenesis during HIV infection. However, it is not known whether Vpr-induced apoptosis depends on the ability of Vpr to induce G2 arrest, and the dynamics of Vpr-induced G2 arrest and apoptosis have not been visualized. We performed time-lapse imaging to examine the temporal relationship between Vpr-induced G2 arrest and apoptosis using HeLa cells containing the fluorescent ubiquitination-based cell cycle indicator2 (Fucci2. The dynamics of G2 arrest and subsequent long-term mitotic cell rounding in cells transfected with the Vpr-expression vector were visualized. These cells underwent nuclear mis-segregation after prolonged mitotic processes and then entered G1 phase. Some cells subsequently displayed evidence of apoptosis after prolonged mitotic processes and nuclear mis-segregation. Interestingly, Vpr-induced apoptosis was seldom observed in S or G2 phase. Likewise, visualization of synchronized HeLa/Fucci2 cells infected with an adenoviral vector expressing Vpr clearly showed that Vpr arrests the cell cycle at G2 phase, but does not induce apoptosis at S or G2 phase. Furthermore, time-lapse imaging of HeLa/Fucci2 cells expressing SCAT3.1, a caspase-3-sensitive fusion protein, clearly demonstrated that Vpr induces caspase-3-dependent apoptosis. Finally, to examine whether the effects of Vpr on G2 arrest and apoptosis were reversible, we performed live-cell imaging of a destabilizing domain fusion Vpr, which enabled rapid stabilization and destabilization by Shield1. The effects of Vpr on G2 arrest and subsequent apoptosis were reversible. This study is the first to

  19. [Definitions and prevention of cardiorespiratory arrest in children]. (United States)

    Carrillo Alvarez, A; López-Herce Cid, J


    In cardiopulmonary resuscitation ages are divided in neonates (in the inmediate period after the birth), infant (from birth to 12 months) and child (from 12 months to puberty). Respiratory arrest is defined by the absence of spontaneous respiration (apnea) or a severe respiratory insufficiency (agonal gasping) that require respiratory assistance. Cardiac arrest is defined as the absence of central arterial pulse or signs of circulation (movement, cough or normal breathing) or the presence of a central pulse less than 60 lpm in a child who does not respond, not breath and with poor perfusion. After resuscitation the return of spontaneous circulation is defined as the recuperation of central arterial pulse or signs of circulation in a child with previous cardiorespiratory arrest. It is maintained when the duration is longer than 20 minutes. Injuries, sudden infant death syndrome, and respiratory diseases are the most frequent etiologies of cardiorrespiratory arrest in children. The prevention and the formation of citizens in basic cardiopulmonary resuscitation are the most effective measures to reduce the mortality of cardiorespiratory arrest in children.

  20. Serum tau and neurological outcome in cardiac arrest

    DEFF Research Database (Denmark)

    Mattsson, Niklas; Zetterberg, Henrik; Nielsen, Niklas


    OBJECTIVE: To test serum tau as a predictor of neurological outcome after cardiac arrest. METHODS: We measured the neuronal protein tau in serum at 24, 48, and 72 hours after cardiac arrest in 689 patients in the prospective international Target Temperature Management trial. The main outcome...... was poor neurological outcome, defined as Cerebral Performance Categories 3-5 at 6 months. RESULTS: Increased tau was associated with poor outcome at 6 months after cardiac arrest (median = 38.5, interquartile range [IQR] = 5.7-245ng/l in poor vs median = 1.5, IQR = 0.7-2.4ng/l in good outcome, for tau....... The accuracy in predicting outcome by serum tau was equally high for patients randomized to 33 °C and 36 °C targeted temperature after cardiac arrest. INTERPRETATION: Serum tau is a promising novel biomarker for prediction of neurological outcome in patients with cardiac arrest. It may be significantly better...

  1. Loss-of-function mutants and overexpression lines of the Arabidopsis cyclin CYCA1;2/Tardy Asynchronous Meiosis exhibit different defects in prophase-i meiocytes but produce the same meiotic products.

    Directory of Open Access Journals (Sweden)

    Yixing Wang

    Full Text Available In Arabidopsis, loss-of-function mutations in the A-type cyclin CYCA1;2/Tardy Asynchronous Meiosis (TAM gene lead to the production of abnormal meiotic products including triads and dyads. Here we report that overexpression of TAM by the ASK1:TAM transgene also led to the production of triads and dyads in meiosis, as well as shriveled seeds, in a dominant fashion. However, the partial loss-of-function mutant tam-1, an ASK1:TAM line, and the wild type differed in dynamic changes in chromosome thread thickness from zygotene to diplotene. We also found that the pericentromeric heterochromatin regions in male meiocytes in tam-1 and tam-2 (a null allele frequently formed a tight cluster at the pachytene and diplotene stages, in contrast to the infrequent occurrences of such clusters in the wild type and the ASK1:TAM line. Immunolocalization studies of the chromosome axial component ASY1 revealed that ASY1 was highly expressed at the appropriate male meiotic stages but not localized to the chromosomes in tam-2. The level of ASY1, however, was greatly reduced in another ASK1:TAM line with much overexpressed TAM. Our results indicate that the reduction and increase in the activity of TAM differentially affect chromosomal morphology and the action of ASY1 in prophase I. Based on these results, we propose that either the different meiotic defects or a common defect such as missing ASY1 on the chromosomal axes triggers a hitherto uncharacterized cell cycle checkpoint in the male meiocytes in the tam mutants and ASK1:TAM lines, leading to the production of the same abnormal meiotic products.

  2. Cardiac arrest following ventilator fire: A rare cause

    Directory of Open Access Journals (Sweden)

    K Nazeer Ahmed


    Full Text Available Operating room fires are rare events, but when occur they result in serious and sometimes fatal consequences. Anaesthesia ventilator fire leading to cardiac arrest is a rare incident and has not been reported. We report a near catastrophic ventilator fire leading to cardiac arrest in a patient undergoing subtotal thyroidectomy. In the present case sparks due to friction or electrical short circuit within the ventilator might have acted as source of ignition leading to fire and explosion in the oxygen rich environment. The patient was successfully resuscitated and revived with uneventful recovery and no adverse sequelae. The cardiac arrest was possibly due to severe hypoxia resulting from inhalation of smoke containing high concentrations of carbon monoxide and other noxious gases.

  3. The role of vasopressin in cardiorespiratory arrest and pulmonary hypertension. (United States)

    Smith, A M; Elliot, C M; Kiely, D G; Channer, K S


    Vasopressin is a peptide synthesized in the hypothalamus whose primary role is in fluid homeostasis. It has recently gained interest as a potential agent in the treatment of cardiorespiratory arrest. Initial human studies have shown benefits with vasopressin in patients with out of hospital ventricular fibrillation and asystolic cardiac arrest. One subgroup of patients not included in these trials is patients with pulmonary hypertension, who have a five-year mortality rate of 50%. Animal studies have shown vasopressin to be a vasodilator in the pulmonary vascular system of rats, under normoxic and hypoxic conditions, with conflicting results in canines. Human studies have shown conflicting results with increases, decreases and no changes seen in pulmonary artery pressures of patients with a variety of clinical conditions. Research needs to be done in patients with pulmonary hypertension regarding the potential role of vasopressin during cardiac arrest in this subgroup.

  4. [Cardiorespiratory arrest in full term newborn infants: six case reports]. (United States)

    Gatti, H; Castel, C; Andrini, P; Durand, P; Carlus, C; Chabernaud, J L; Vial, M; Dehan, M; Boithias, C


    Cardiorespiratory arrest occurring within the first two hours of life of a perfectly normal newborn is a very seldom event hitherto unreported. Six infants born after an uneventful pregnancy by normal vaginal delivery, with a normal Apgar score and physical examination, were found with unexpected cardiorespiratory arrest requiring cardiac and respiratory resuscitation early after birth. All were lying in the prone position, their face covered up while facing mother's abdomen, breast or neck. All mothers were primipara. All newborns but one died. Biological and bacteriological samples were normal and early onset neonatal sepsis was ruled out. Autopsy, performed in five infants, was not contributive. We hypothesize that the sudden and unexpected cardiorespiratory arrest occurring in these normal newborns was secondary to acute upper airway obstruction. To prevent this life threatening post-natal asphyxic episode, it is essential to ensure that the face of a newborn lying down upon mother's breast and abdomen is properly and continuously cleared.

  5. The optimal hemodynamics management of post-cardiac arrest shock. (United States)

    Pellis, Tommaso; Sanfilippo, Filippo; Ristagno, Giuseppe


    Patients resuscitated from cardiac arrest develop a pathophysiological state named "post-cardiac arrest syndrome." Post-resuscitation myocardial dysfunction is a common feature of this syndrome, and many patients eventually die from cardiovascular failure. Cardiogenic shock accounts for most deaths in the first 3 days, when post-resuscitation myocardial dysfunction peaks. Thus, identification and treatment of cardiovascular failure is one of the key therapeutic goals during hospitalization of post-cardiac arrest patients. Patients with hemodynamic instability may require advanced cardiac output monitoring. Inotropes and vasopressors should be considered if hemodynamic goals are not achieved despite optimized preload. If these measures fail to restore adequate organ perfusion, a mechanical circulatory assistance device may be considered. Adequate organ perfusion should be ensured in the absence of definitive data on the optimal target pressure goals. Hemodynamic goals should also take into account targeted temperature management and its effect on the cardiovascular function. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Macrolide antibiotics allosterically predispose the ribosome for translation arrest. (United States)

    Sothiselvam, Shanmugapriya; Liu, Bo; Han, Wei; Ramu, Haripriya; Klepacki, Dorota; Atkinson, Gemma Catherine; Brauer, Age; Remm, Maido; Tenson, Tanel; Schulten, Klaus; Vázquez-Laslop, Nora; Mankin, Alexander S


    Translation arrest directed by nascent peptides and small cofactors controls expression of important bacterial and eukaryotic genes, including antibiotic resistance genes, activated by binding of macrolide drugs to the ribosome. Previous studies suggested that specific interactions between the nascent peptide and the antibiotic in the ribosomal exit tunnel play a central role in triggering ribosome stalling. However, here we show that macrolides arrest translation of the truncated ErmDL regulatory peptide when the nascent chain is only three amino acids and therefore is too short to be juxtaposed with the antibiotic. Biochemical probing and molecular dynamics simulations of erythromycin-bound ribosomes showed that the antibiotic in the tunnel allosterically alters the properties of the catalytic center, thereby predisposing the ribosome for halting translation of specific sequences. Our findings offer a new view on the role of small cofactors in the mechanism of translation arrest and reveal an allosteric link between the tunnel and the catalytic center of the ribosome.

  7. Arrester Resistive Current Measuring System Based on Heterogeneous Network (United States)

    Zhang, Yun Hua; Li, Zai Lin; Yuan, Feng; Hou Pan, Feng; Guo, Zhan Nan; Han, Yue


    Metal Oxide Arrester (MOA) suffers from aging and poor insulation due to long-term impulse voltage and environmental impact, and the value and variation tendency of resistive current can reflect the health conditions of MOA. The common wired MOA detection need to use long cables, which is complicated to operate, and that wireless measurement methods are facing the problems of poor data synchronization and instability. Therefore a novel synchronous measurement system of arrester current resistive based on heterogeneous network is proposed, which simplifies the calculation process and improves synchronization, accuracy and stability and of the measuring system. This system combines LoRa wireless network, high speed wireless personal area network and the process layer communication, and realizes the detection of arrester working condition. Field test data shows that the system has the characteristics of high accuracy, strong anti-interference ability and good synchronization, which plays an important role in ensuring the stable operation of the power grid.

  8. The Evolving Paradigm of Individualized Postresuscitation Care After Cardiac Arrest. (United States)

    Seder, David B; Lord, Christine; Gagnon, David J


    The postresuscitation period after a cardiac arrest is characterized by a wide range of physiological derangements. Variations between patients include preexisting medical problems, the underlying cause of the cardiac arrest, presence or absence of hemodynamic and circulatory instability, severity of the ischemia-reperfusion injury, and resuscitation-related injuries such as pulmonary aspiration and rib or sternal fractures. Although protocols can be applied to many elements of postresuscitation care, the widely disparate clinical condition of cardiac arrest survivors requires an individualized approach that stratifies patients according to their clinical profile and targets specific treatments to patients most likely to benefit. This article describes such an individualized approach, provides a practical framework for evaluation and triage at the bedside, and reviews concerns specific to all members of the interprofessional postresuscitation care team. ©2016 American Association of Critical-Care Nurses.

  9. Numerical study of fracture arrest on snow cover

    Directory of Open Access Journals (Sweden)

    B. Frigo


    Full Text Available Under the hypothesis of a perfectly brittle phenomenon, avalanche triggering can be investigated numerically by means of Linear Elastic Fracture Mechanics (LEFM. Since, however, the real phenomenon is intrinsically dynamical, another aspect to investigate is represented by dynamic fracture propagation. In this paper, we model dynamic crack propagation into a dry snow slab and we investigate the possibility to arrest the crack propagation through the presence of weak zones distributed along the extension of the snow slope. Assuming that the weak layer is almost collapsed, we simulate the efficiency of artificial voids in the slab to arrest fracture propagation, into the framework of Dynamical Fracture Mechanics. We put forward here a new philosophy for the use of artificial discontinuities (void into the snowpack able to perform as crack arresters distributed along the snow slope area: the target is to split a large avalanche slab into smaller slabs, causing small avalanches to propagate with less catastrophic effects.

  10. Crack arrest toughness measurements with A533B steel

    International Nuclear Information System (INIS)

    Salonen, Seppo.


    This work covers crack arrest toughness measurements on A533B steel done at the Technical Research Centre of Finland. These measurements are one part of a multinational effort, involving 30 laboratories. The aim of the cooperative test program is to examine two test procedures for measuring the crack arrest toughness, to give information about their reproducibility, and to identify the factors affecting the interpretation. The principles given for the testing were easy to apply in general and the results were satisfactory. Some factors in the test runs and in the specimen's behaviour are indicated which can cause error in the results or make implementation of the test more difficult. By comparing the results from our laboratory with average values from the test program a good agreement can be seen. Crack arrest toughness values derived from the compared procedures with a static analysis agree closely, but values calculated using a dynamic analysis differ considerably. (author)

  11. Allyl isothiocyanate arrests cancer cells in mitosis, and mitotic arrest in turn leads to apoptosis via Bcl-2 protein phosphorylation. (United States)

    Geng, Feng; Tang, Li; Li, Yun; Yang, Lu; Choi, Kyoung-Soo; Kazim, A Latif; Zhang, Yuesheng


    Allyl isothiocyanate (AITC) occurs in many commonly consumed cruciferous vegetables and exhibits significant anti-cancer activities. Available data suggest that it is particularly promising for bladder cancer prevention and/or treatment. Here, we show that AITC arrests human bladder cancer cells in mitosis and also induces apoptosis. Mitotic arrest by AITC was associated with increased ubiquitination and degradation of α- and β-tubulin. AITC directly binds to multiple cysteine residues of the tubulins. AITC induced mitochondrion-mediated apoptosis, as shown by cytochrome c release from mitochondria to cytoplasm, activation of caspase-9 and caspase-3, and formation of TUNEL-positive cells. Inhibition of caspase-9 blocked AITC-induced apoptosis. Moreover, we found that apoptosis induction by AITC depended entirely on mitotic arrest and was mediated via Bcl-2 phosphorylation at Ser-70. Pre-arresting cells in G(1) phase by hydroxyurea abrogated both AITC-induced mitotic arrest and Bcl-2 phosphorylation. Overexpression of a Bcl-2 mutant prevented AITC from inducing apoptosis. We further showed that AITC-induced Bcl-2 phosphorylation was caused by c-Jun N-terminal kinase (JNK), and AITC activates JNK. Taken together, this study has revealed a novel anticancer mechanism of a phytochemical that is commonly present in human diet.

  12. Swedish ambulance nurses' experiences of nursing patients suffering cardiac arrest. (United States)

    Larsson, Ricard; Engström, Åsa


    Effective pre-hospital treatment of a person suffering cardiac arrest is a challenging task for the ambulance nurses. The aim of this study was to describe ambulance nurses' experiences of nursing patients suffering cardiac arrest. Qualitative personal interviews were conducted during 2011 in Sweden with seven ambulance nurses with experience of nursing patients suffering cardiac arrests. The interview texts were analyzed using qualitative thematic content analysis, which resulted in the formulation of one theme with six categories. Mutual preparation, regular training and education were important factors in the nursing of patients suffering cardiac arrest. Ambulance nurses are placed in ethically demanding situations regarding if and for how long they should continue cardio-pulmonary resuscitation (CPR) to accord with pre-hospital cardiac guidelines and patients' wishes. When a cardiac arrest patient is nursed their relatives also need the attention of ambulance nurses. Reflection is one way for ambulance nurses to learn from, and talk about, their experiences. This study provides knowledge of ambulance nurses' experiences in the care of people with cardiac arrest. Better feedback about the care given by the ambulance nurses, and about the diagnosis and nursing care the patients received after they were admitted to the hospital are suggested as improvements that would allow ambulance nurses to learn more from their experience. Further development and research concerning the technical equipment might improve the situation for both the ambulance nurses and the patients. Ambulance nurses need regularly training and education to be prepared for saving people's lives and also to be able to make the right decisions. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Two novel anoxia-induced ethylene response factors that interact with promoters of deastringency-related genes from persimmon.

    Directory of Open Access Journals (Sweden)

    Ting Min

    Full Text Available A hypoxic environment is generally undesirable for most plants and stimulates anaerobic metabolism. It is a beneficial treatment, however, for the removal of astringency from persimmon to improve the fruit quality after harvest. High soluble tannins (SCTs content is one of most important causes of astringency. High CO2 (95% treatment effectively reduced SCTs in both "Mopan" and "Gongcheng-shuishi" persimmon fruit by causing increases in acetaldehyde. Using RNA-seq and realtime PCR, twelve ethylene response factor genes (DkERF11-22 were isolated and characterized, to determine those responsive to high CO2 treatment. Only two genes, DkERF19 and DkERF22, showed trans-activation effects on the promoters of deastringency-related genes pyruvate decarboxylase genes (DkPDC2 and DkPDC3 and the transcript levels of these genes was enhanced by hypoxia. Moreover, DkERF19 and the previously isolated DkERF9 had additive effects on activating the DkPDC2 promoter. Taken together, these results provide further evidence that transcriptome changes in the level of DkERF mRNAs regulate deastringency-related genes and their role in the mechanism of persimmon fruit deastringency is discussed.

  14. Complete maternal and fetal recovery after prolonged cardiac arrest. (United States)

    Selden, B S; Burke, T J


    A case of complete maternal and fetal recovery after prolonged cardiac arrest from massive lidocaine overdose is presented. A 27-year-old woman at 15 weeks gestation had a complete neurologic recovery after 22 minutes of CPR, including 19 minutes of electromechanical dissociation and asystole, with normal fetal heart function and fetal motion confirmed by ultrasound immediately after resuscitation. The patient delivered a healthy and neurologically normal infant at 40 weeks gestation. This is the longest cardiac arrest in early pregnancy reported in the medical literature with normal maternal and fetal outcome.

  15. Oxidative phosphorylation as a target to arrest malignant neoplasias. (United States)

    Rodríguez-Enríquez, Sara; Gallardo-Pérez, Juan Carlos; Marín-Hernández, Alvaro; Aguilar-Ponce, José Luis; Mandujano-Tinoco, Edna Ayerim; Meneses, Abelardo; Moreno-Sánchez, Rafael


    Since Warburg proposed in 1956 that cancer cells exhibit increased glycolysis due to mitochondrial damage, numerous researchers have assumed that glycolysis is the predominant ATP supplier for cancer cell energy-dependent processes. However, chemotherapeutic strategies using glycolytic inhibitors have been unsuccessful in arresting tumor proliferation indicating that the Warburg hypothesis may not be applicable to all existing neoplasias. This review analyzes recent information on mitochondrial metabolism in several malignant neoplasias emphasizing that, although tumor cells maintain a high glycolytic rate, the principal ATP production may derive from active oxidative phosphorylation. Thus, anti-mitochondrial drug therapy may be an adequate adjuvant strategy to arrest proliferation of oxidative phosphorylation-dependent neoplasias.

  16. Interrater variability of EEG interpretation in comatose cardiac arrest patients

    DEFF Research Database (Denmark)

    Westhall, Erik; Rosén, Ingmar; Rossetti, Andrea O


    OBJECTIVE: EEG is widely used to predict outcome in comatose cardiac arrest patients, but its value has been limited by lack of a uniform classification. We used the EEG terminology proposed by the American Clinical Neurophysiology Society (ACNS) to assess interrater variability in a cohort.......42) for malignant patterns. Substantial agreement was found for malignant periodic or rhythmic patterns (κ 0.72) while agreement for identifying an unreactive EEG was fair (κ 0.26). CONCLUSIONS: The ACNS EEG terminology can be used to identify highly malignant EEG-patterns in post cardiac arrest patients...

  17. Interfacial crack arrest in sandwich beams subjected to fatigue loading using a novel crack arresting device – Numerical modelling

    DEFF Research Database (Denmark)

    Martakos, G.; Andreasen, J.H.; Berggreen, Christian


    A novel crack arresting device is implemented in foam-cored composite sandwich beams and tested using the Sandwich Tear Test (STT) configuration. A finite element model of the setup is developed, and the predictions are correlated with observations and results from a recently conducted experimental...... fatigue test study. Based on a linear elastic fracture mechanics approach, the developed FE model is utilised to simulate crack propagation and arrest in foam-cored sandwich beam specimens subjected to fatigue loading conditions. The effect of the crack arresters on the fatigue life is analysed......, and the predictive results are subsequently compared with the observations from the previously conducted fatigue tests. The FE model predicts the energy release rate and the mode mixity based on the derived crack surface displacements, utilising algorithms for the prediction of accelerated fatigue crack growth...

  18. Cardiac Arrest after Local Anaesthetic Toxicity in a Paediatric Patient

    Directory of Open Access Journals (Sweden)

    Liana Maria Torres de Araújo Azi


    Full Text Available We report a case of a paediatric patient undergoing urological procedure in which a possible inadvertent intravascular or intraosseous injection of bupivacaine with adrenaline in usual doses caused subsequent cardiac arrest, completely reversed after administration of 20% intravenous lipid emulsion. Early diagnosis of local anaesthetics toxicity and adequate cardiovascular resuscitation manoeuvres contribute to the favourable outcome.

  19. Offenders' Perceptions of House Arrest and Electronic Monitoring (United States)

    Martin, Jamie S.; Hanrahan, Kate; Bowers, James H., Jr.


    This article reports on a study designed to examine the perceptions of house arrest (HA) and electronic monitoring (EM) among offenders who have recently experienced this criminal sentence. Data were gathered via a self-administered questionnaire and follow-up interviews with a sample of offenders. Our primary areas of interest were to assess (a)…

  20. Sudden cardiac arrest risk in young athletes | Gradidge | South ...

    African Journals Online (AJOL)

    Underlying cardiac abnormalities are the main cause of unexpected death in athletes on field. These abnormalities have been associated with a previous history of syncope, a family history of sudden cardiac arrest (SCA), cardiac murmur, a history of over-exhaustion post exercise and ventricular tachyarrhythmia during ...

  1. Early hypercementosis and arrested dental eruption: heritable multiple ankylodontia. (United States)

    Israel, H


    This study describes arrested posterior permanent tooth eruption in association with hypercementosis, reduction of the periodontal ligamental space, and bony ankylosis. The severe dental malocclusion occurred in four members of the same family and it appears to have an autosomal dominant mode of inheritance.

  2. 19 CFR 162.63 - Arrests and seizures. (United States)


    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Arrests and seizures. 162.63 Section 162.63 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) INSPECTION, SEARCH, AND SEIZURE Controlled Substances, Narcotics, and Marihuana § 162...

  3. Trichostrongylus colubriformis rDNA polymorphism associated with arrested development

    Czech Academy of Sciences Publication Activity Database

    Langrová, I.; Zouhar, M.; Vadlejch, J.; Borovský, M.; Jankovská, I.; Lytvynets, Andrej


    Roč. 103, č. 2 (2008), s. 401-403 ISSN 0932-0113 Institutional research plan: CEZ:AV0Z50110509 Keywords : arrested development * polymorphism * rDNA Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.473, year: 2008

  4. Prediction of cardiac arrest recurrence using ensemble classifiers

    Indian Academy of Sciences (India)

    Home; Journals; Sadhana; Volume 42; Issue 7. Prediction of cardiac arrest recurrence using ensemble classifiers. NACHIKET TAPAS ... Poor survival rate of patients with SCA is one of themost ubiquitous health care problems today. Recent studies show that heart-rate-derived features can act as early predictors of SCA.

  5. Anaphylactic shock and cardiac arrest caused by thiamine infusion

    DEFF Research Database (Denmark)

    Juel, Jacob; Pareek, Manan; Langfrits, Christian Sigvald


    intoxication and developed cardiac arrest due to anaphylactic shock following intravenous thiamine infusion. The patient was successfully resuscitated after 15 min and repeated epinephrine administrations. He was discharged in good health after 14 days. This case report emphasises both the importance...

  6. [Refractory cardiac arrest patients in prehospital care, potential organ donors]. (United States)

    Le Jan, Arnaud; Dupin, Aurélie; Garrigue, Bruno; Sapir, David


    Under the authority of the French Biomedicine Agency, a new care pathway integrates refractory cardiac arrest patients into a process of organ donation. It is a medical, logistical and ethical challenge for the staff of the mobile emergency services. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Cdc20 control of cell fate during prolonged mitotic arrest

    DEFF Research Database (Denmark)

    Nilsson, Jakob


    The fate of cells arrested in mitosis by antimitotic compounds is complex but is influenced by competition between pathways promoting cell death and pathways promoting mitotic exit. As components of both of these pathways are regulated by Cdc20-dependent degradation, I hypothesize that variations...

  8. Carbamazepine induces mitotic arrest in mammalian Vero cells

    International Nuclear Information System (INIS)

    Perez Martin, J.M.; Fernandez Freire, P.; Labrador, V.; Hazen, M.J.


    We reported recently that the anticonvulsant drug carbamazepine, at supratherapeutic concentrations, exerts antiproliferative effects in mammalian Vero cells, but the underlying mechanism has not been elucidated. This motivates us to examine rigorously whether growth arrest was associated with structural changes in cellular organization during mitosis. In the present work, we found that exposure of the cells to carbamazepine led to an increase in mitotic index, mainly due to the sustained block at the metaphase/anaphase boundary, with the consequent inhibition of cell proliferation. Indirect immunofluorescence, using antibodies directed against spindle apparatus proteins, revealed that mitotic arrest was associated with formation of monopolar spindles, caused by impairment of centrosome separation. The final consequence of the spindle defects induced by carbamazepine, depended on the duration of cell cycle arrest. Following the time course of accumulation of metaphase and apoptotic cells during carbamazepine treatments, we observed a causative relationship between mitotic arrest and induction of cell death. Conversely, cells released from the block of metaphase by removal of the drug, continued to progress through mitosis and resume normal proliferation. Our results show that carbamazepine shares a common antiproliferative mechanism with spindle-targeted drugs and contribute to a better understanding of the cytostatic activity previously described in Vero cells. Additional studies are in progress to extend these initial findings that define a novel mode of action of carbamazepine in cultured mammalian cells

  9. Lupeol induces S-phase arrest and mitochondria-mediated ...

    Indian Academy of Sciences (India)


    Lupeol induces S-phase arrest and mitochondria-mediated apoptosis in cervical cancer cells. Nupoor Prasad1, Akash Sabarwal2, Umesh C. S. Yadav1, Rana P. Singh2,*. 1School of Life Sciences, Central University of Gujarat, Gandhinagar, Gujarat, India. 2Cancer Biology Laboratory, School of Life Sciences, Jawaharlal ...

  10. Is Ward Experience in Resuscitation Effort Related to the Prognosis of Unexpected Cardiac Arrest?

    Directory of Open Access Journals (Sweden)

    Sen-Kuang Hou


    Conclusion: Hospital wards with more than 5 cardiac arrests per year have a better patient survival rate than those with fewer arrests. This is despite all ward staff receiving the same level of training.

  11. The arresting phase determines the total healing time of

    Directory of Open Access Journals (Sweden)

    LI Ping


    Full Text Available 【Abstract】Objective: Radiation is an important cause of delayed wound healing, and there still exist many questions regarding the patterns and mechanisms of wound healing. This study investigated the characteristics of wound healing after varying doses of local radiation and explored possible causes of the delay in healing caused by radiation. Methods: A full-thickness dorsal longitudinal skin tissue, 2 cm in diameter, was excised after local irradiation on one side of the back of swine, and the other side was wounded as a control. The size of the wound area was re-corded every two days after injury. Pathological changes, proliferating cell nuclear antigen (PCNA, immunohisto-chemistry and apoptosis levels (TUNEL assay were mea-sured at different time points after wounding. Results: The course of wound healing can be divided into four phases, namely: the arresting phase, the healing priming phase, the fast healing phase, and the healed phase. Although the total wound healing time was closely corre-lated to the dose of irradiation (R 2 = 0.9758, it was more dependent on the length of the arresting phase (R 2 =0.9903 because once the arresting phase ended, the wound healed at a similar speed regardless of radiation doses. Pathologi-cal analysis showed that compared with the control side there were more necrotic tissues, slower epithelial crawling, as well as fewer blood vessels and cellular components in the irradiated side at the arresting phase, while other phases revealed no significant difference concerning these measurements. Immunohistochemistry showed that the ir-radiated wounds had significantly less PCNA-positive and more TUNEL-positive labeling of cells in the arresting phase than in other phases. Moreover, the changes were posi-tively related to the radiation doses, but there was no obvi-ous difference in cell proliferation or apoptosis among the healing priming phase, fast healing phase or healed phase, whether on the control side

  12. Long-term outcome of paediatric cardiorespiratory arrest in Spain. (United States)

    López-Herce, Jesús; García, Cristina; Rodríguez-Núñez, Antonio; Domínguez, Pedro; Carrillo, Angel; Calvo, Custodio; Delgado, Miguel Angel


    To analyse the final outcome of cardiorespiratory arrest (CRA) in children and the neurological and functional state of survivors at 1 year. An 18-month prospective, multicentre study analysing out-of-hospital and in-hospital CRA in children was carried out; 283 children between 7 days and 17 years of age were included. CRA and resuscitation data were registered according to Utstein style. The outcome variables were: sustained return of spontaneous circulation (initial survival), and survival at 1 year (final survival). The status of survivors was evaluated by means of the paediatric cerebral performance category (PCPC) scale and the paediatric overall performance category (POPC) scale at Paediatric Intensive Care Unit discharge, at hospital discharge, and at 1 year follow-up. In 283 children, 311 CRA episodes, 73 respiratory arrests (23.5%) and 238 cardiac arrests (76.5%) were analysed. Seventeen children suffered more than one CRA episode (range: 2-6). The initial survival was 60.2% and 1-year survival was 33.2%. The final survival was significantly higher in respiratory arrest than in cardiac arrest patients (70.0% versus 21.1%) (P < 0.0001). After 1 year follow-up, 87.3% of patients had scores 1 or 2 on the PCPC scale and 84.0% had scores 1 or 2 in the POPC scale; these results indicate that 1 year after CRA, the majority of survivors had normal neurological and functional status or showed only mild disability. Prognosis of CRA in children continues to be poor in terms of survival but quite good in terms of neurological and functional status among survivors. Additional strategies and efforts are needed to improve the short-term prognosis of paediatric CRA. However, the long-term outcome of survivors is reassuring.

  13. Explaining Discrepancies in Arrest Rates Between Black and White Male Juveniles


    Fite, Paula J.; Wynn, Porche’; Pardini, Dustin A.


    The authors investigated discrepancies in arrest rates between Black and White male juveniles by examining the role of early risk factors for arrest. Two hypotheses were evaluated: (a) Disproportionate minority arrest is due to increased exposure to early risk factors, and (b) a differential sensitivity to early risk factors contributes to disproportionate minority arrest. The study included 481 Black and White boys who were followed from childhood to early adulthood. A higher incidence of ea...

  14. Gender and Relational-Distance Effects in Arrests for Domestic Violence (United States)

    Lally, William; DeMaris, Alfred


    This study tests two hypotheses regarding factors affecting arrest of the perpetrator in domestic violence incidents. Black's relational-distance thesis is that the probability of arrest increases with increasing relational distance between perpetrator and victim. Klinger's leniency principle suggests that the probability of arrest is lower for…

  15. U.S. Juvenile Arrests: Gang Membership, Social Class, and Labeling Effects (United States)

    Tapia, Mike


    This study addresses the link between gang membership and arrest frequency, exploring the Gang x Socioeconomic status interaction on those arrests. Notoriously poor, delinquent, and often well-known to police, America's gang youth should have very high odds of arrest. Yet it is unclear whether mere membership in a gang increases the risk of arrest…

  16. 30 CFR 75.521 - Lightning arresters; ungrounded and exposed power conductors and telephone wires. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Lightning arresters; ungrounded and exposed... Electrical Equipment-General § 75.521 Lightning arresters; ungrounded and exposed power conductors and... leads underground shall be equipped with suitable lightning arresters of approved type within 100 feet...

  17. Local Immigration Enforcement and Arrests of the Hispanic Population

    Directory of Open Access Journals (Sweden)

    Michael Coon


    Full Text Available Section 287(g of the Immigration and Nationality Act (INA, which was added to the INA by the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA, allows the federal government to enter into voluntary partnerships with state and local law enforcement agencies to enforce immigration law. Upon entering these agreements, law enforcement officers are trained by Immigration and Customs Enforcement (ICE and receive delegated authority to enquire about an individual’s immigration status and, if found to be removable, to detain the individual while ICE makes a determination of whether to initiate deportation proceedings. In some instances, this inquiry about immigration status takes place as part of the intake process when a criminal defendant is arrested and placed into a criminal jail. In other instances, task force officers are trained to inquire in the field about immigration status and enforce immigration law against people who have not committed any criminal offense.  The key difference between the two models is that task force agents can arrest for immigration violations undocumented individuals who have not committed any criminal offense, whereas in the jail model individuals must be arrested on some other criminal charge before immigration status can be determined. The 287(g program has raised several concerns regarding its implementation and results. First, the program could lead to racial and ethnic profiling. In particular, given that the majority of undocumented immigrants hail from Latin American countries, it is highly plausible that Hispanics, regardless of immigrant status, might be disproportionally affected by this program. That is, in a jurisdiction that participates in the jail model, an officer might arrest a Hispanic individual for a very minor offence in order to process them through the jail and determine their immigration status, when perhaps without the program they may have only issued a citation

  18. A Case of Morgagni Hernia Resulting with Respiratory Arrest

    Directory of Open Access Journals (Sweden)

    Cavit Çöl


    Full Text Available Morgagni’s hernia is seen at a rate of 3-4% among all diaphragmatic hernias. It develops from a defect in the pleuroperitoneal membrane. Herniation of the omentum is seen most commonly, that of the colon frequently, and herniation of small bowel and stomach is seen rarely. When being examined due to anemia and dyspnea, a 53-year-old male patient suffered from a respiratory arrest and was hence intubated and placed under treatment at the intensive care unit. On radiological examination, a giant diaphragmatic hernia was observed bilaterally, more marked on the right side. On laparotomy, especially on the right side, the caecum, the ascending colon, the transverse colon, the appendix, the omentum and part of the small bowel was seen to be herniated. Primary diaphragmatic repair + right hemicolectomy + end-to-end ileo-transversostomy was performed. We have reported this case because it was a giant hernia which caused respiratory arrest.

  19. [Hypothermia after cardiac arrest--underused method that saves lives]. (United States)

    Gornik, Ivan; Peklić, Marina; Gasparović, Vladimir


    Cardiorespiratory arrest causes ischemia and lesion of all organ systems, but the central nervous system is the most vulnerable. It is known that only few minutes of hypoperfusion and ischemia can cause irreversible damage to the brain which is the major frustration of reanimatology. Results of clinical trials suggest positive effects of hypothermia on survival and neurological recovery which led to including this method to Guidelines for resuscitation as a recommended standard method in post-resuscitation period for patients who have not regained consciousness. Methods for induction and maintenance of hypothermia are numerous and various, basically divided into invasive and non-invasive, each with its own advantages and disadvantages which are described in this paper. Despite recognised positive effects of mild therapeutic hypothermia after resuscitation from cardiac arrest, the method is not fully implemented as a standard method in post-resuscitation period.

  20. Metazoan operons accelerate recovery from growth arrested states (United States)

    Zaslaver, Alon; Baugh, L. Ryan; Sternberg, Paul W.


    Summary Existing theories explain why operons are advantageous in prokaryotes, but their occurrence in metazoans is an enigma. Nematode operon genes, typically consisting of growth genes, are significantly up-regulated during recovery from growth-arrested states. This expression pattern is anti-correlated to non-operon genes consistent with a competition for transcriptional resources. We find that transcriptional resources are initially limiting during recovery, and that recovering animals are highly sensitive to any additional decrease in transcriptional resources. Operons become advantageous because by clustering growth genes into operons, fewer promoters compete for the limited transcriptional machinery, effectively increasing the concentration of transcriptional resources, and accelerating recovery. Mathematical modeling reveals how a moderate increase in transcriptional resources can substantially enhance transcription rate and recovery. This design principle occurs in different nematodes and the chordate C. intestinalis. As transition from arrest to rapid growth is shared by many metazoans, operons could have evolved to facilitate these processes. PMID:21663799

  1. Cardiac arrest related to anaesthesia in Williams-Beuren syndrome. (United States)

    Lucena Delgado, J; Sanabria Carretero, P; Durán la Fuente, P; Gónzalez Rocafort, A; Castro Parga, L; Reinoso Barbero, F


    Williams-Beuren syndrome is the clinical manifestation of a congenital genetic disorder in the elastin gene, among others. There is a history of cardiac arrest refractory to resuscitation manoeuvres in anaesthesia. The incidence of myocardial ischaemia is high during anaesthetic induction, but there are patients who do not have this condition yet also have had very serious cardiac events, and issues that are still to be resolved. Case descriptions will enable the common pathophysiological factors to be defined, and decrease morbidity and mortality. We report the case of a 3-year-old boy with cardiac arrest at induction, rescued with circulatory assistance with extracorporeal membrane oxygenation and hypothermia induced for cerebral protection. Copyright © 2017 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Arrested of coalescence of emulsion droplets of arbitrary size (United States)

    Mbanga, Badel L.; Burke, Christopher; Blair, Donald W.; Atherton, Timothy J.


    With applications ranging from food products to cosmetics via targeted drug delivery systems, structured anisotropic colloids provide an efficient way to control the structure, properties and functions of emulsions. When two fluid emulsion droplets are brought in contact, a reduction of the interfacial tension drives their coalescence into a larger droplet of the same total volume and reduced exposed area. This coalescence can be partially or totally hindered by the presence of nano or micron-size particles that coat the interface as in Pickering emulsions. We investigate numerically the dependance of the mechanical stability of these arrested shapes on the particles size, their shape anisotropy, their polydispersity, their interaction with the solvent, and the particle-particle interactions. We discuss structural shape changes that can be induced by tuning the particles interactions after arrest occurs, and provide design parameters for the relevant experiments.

  3. Relationship between chest compression rates and outcomes from cardiac arrest. (United States)

    Idris, Ahamed H; Guffey, Danielle; Aufderheide, Tom P; Brown, Siobhan; Morrison, Laurie J; Nichols, Patrick; Powell, Judy; Daya, Mohamud; Bigham, Blair L; Atkins, Dianne L; Berg, Robert; Davis, Dan; Stiell, Ian; Sopko, George; Nichol, Graham


    Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions per minute. Animal and human studies have reported that blood flow is greatest with chest compression rates near 120/min, but few have reported rates used during out-of-hospital (OOH) cardiopulmonary resuscitation or the relationship between rate and outcome. The purpose of this study was to describe chest compression rates used by emergency medical services providers to resuscitate patients with OOH cardiac arrest and to determine the relationship between chest compression rate and outcome. Included were patients aged ≥ 20 years with OOH cardiac arrest treated by emergency medical services providers participating in the Resuscitation Outcomes Consortium. Data were abstracted from monitor-defibrillator recordings during cardiopulmonary resuscitation. Multiple logistic regression analysis assessed the association between chest compression rate and outcome. From December 2005 to May 2007, 3098 patients with OOH cardiac arrest were included in this study. Mean age was 67 ± 16 years, and 8.6% survived to hospital discharge. Mean compression rate was 112 ± 19/min. A curvilinear association between chest compression rate and return of spontaneous circulation was found in cubic spline models after multivariable adjustment (P=0.012). Return of spontaneous circulation rates peaked at a compression rate of ≈ 125/min and then declined. Chest compression rate was not significantly associated with survival to hospital discharge in multivariable categorical or cubic spline models. Chest compression rate was associated with return of spontaneous circulation but not with survival to hospital discharge in OOH cardiac arrest.

  4. Cerebral vasoconstriction in comatose patients resuscitated from a cardiac arrest? (United States)

    Buunk, G; van der Hoeven, J G; Frölich, M; Meinders, A E


    To determine the role of cerebral vasoconstriction in the delayed hypoperfusion phase in comatose patients after cardiac arrest. Prospective study. Medical intensive care unit in a university hospital. 10 comatose patients (Glasgow Coma Score +/- 6)successfully resuscitated from a cardiac arrest occurring outside the hospital. We measured the pulsatility index (PI) and mean blood flow velocity (MFV) of the middle cerebral artery, the cerebral oxygen extraction ratio and jugular bulb levels of endothelin, nitrate, and cGMP during the first 24 h after cardiac arrest. The PI decreased significantly from 1.86 +/- 1.02 to 1.05 +/- 0.22 (p = 0.03). The MFV increased significantly from 29 +/- 10 to 62 +/- 25 cm/s (p = 0.003). Cerebral oxygen extraction ratio decreased also from 0.39 +/- 0.13 to 0.24 +/- 0.11 (p = 0.015). Endothelin levels were high but did not change during the study period. Nitrate levels varied widely and showed a slight but significant decrease from 37.1 mumol/l (median; 25th-75th percentiles: 26.8-61.6) to 31.3 mumol/l (22.1-39.6) (p = 0.04). Cyclic guanosine monophosphate levels increased significantly from 2.95 mumol/l (median; 25th-75th percentiles: 2.48-5.43) to 7.5 mumol/l (6.20-14.0) (p = 0.02). We found evidence of increased cerebrovascular resistance during the first 24 h after cardiac arrest with persistent high endothelin levels, gradually decreasing nitrate levels, and gradually increasing cGMP levels, This suggests that active cerebral vasoconstriction due to an imbalance between local vasodilators and vasoconstrictors plays a role in the delayed hypoperfusion phase.

  5. High voltage measurements on metal-oxide surge arresters

    Energy Technology Data Exchange (ETDEWEB)

    Yli-Aeyhoe, S. [Tampere University of Technology (Finland). High Voltage Laboratory


    Metal-oxide surge arresters (MOA) are used to prevent damages caused by overvoltages and currents. Because of the function of MOAs they have to be tested with high voltage and with high current. The aim of this seminar paper is to give some information how MOAs can be tested in laboratory circumstances and on- site. Few new test methods are introduced as well. (orig.)

  6. Outcome from paediatric cardiac arrest associated with trauma. (United States)

    Crewdson, K; Lockey, D; Davies, G


    To examine survival rates for paediatric trauma patients requiring cardiopulmonary resuscitation (CPR) in the pre-hospital setting, and to identify characteristics that may be associated with survival. Ten-year retrospective trauma database review. An urban physician-led pre-hospital trauma service serving a population of approximately 7.5 million, in the United Kingdom. Eighty paediatric trauma patients (15 years or less) who received pre-hospital resuscitation following cardiorespiratory arrest between July 1994 and June 2004. Pre-hospital cardiopulmonary resuscitation. Survival to hospital discharge. Eighty children met inclusion criteria for the study. Nineteen (23.8%) were discharged alive from the emergency department and seven children (8.75%) survived to hospital discharge. Of the seven survivors, one had spinal cord injury. Two suffered asphyxial injury associated with blunt trauma and three sustained hypoxic insults following drowning or burns/smoke inhalation. In one patient with known congenital cardiac disease the cause of cardiac arrest was likely to have been medical. This study confirms the poor outcome for children requiring pre-hospital CPR following trauma. However, the results are better in this physician-attended group than in other studies where physicians were not present. They also suggest that cardiac arrest associated with trauma in children has a better outcome than in adults. In common with adults treated in this system, those patients with hypovolaemic cardiac arrest did not survive (Ann Emerg Med 2006;48:240-4). A large proportion of the survivors suffered hypoxic or asphyxial injuries. Targeted aggressive out-of-hospital resuscitation in certain patient groups can produce good outcomes.

  7. [Assessment of professional practices in treating cardiac arrest]. (United States)

    Mazon, Clara; Kerrou, Yamina


    An assessment of professional practices was carried out in 2013-2014 with the aim of improving the treatment of cardiac arrest in hospitals. Two methods were used: an assessment by questionnaire to evaluate theoretical knowledge and a practical assessment of external cardiac massage. The results highlight the need for greater knowledge. The use of cardiac massage must be included in continuing professional development. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Adverse drug reactions in therapeutic hypothermia after cardiac arrest. (United States)

    Witcher, Robert; Dzierba, Amy L; Kim, Catherine; Smithburger, Pamela L; Kane-Gill, Sandra L


    Therapeutic hypothermia (TH) improves survival and neurologic function in comatose survivors of cardiac arrest. Many medications used to support TH have altered pharmacokinetics and pharmacodynamics during this treatment. It is unknown if or at what frequency the medications used during TH cause adverse drug reactions (ADRs). A retrospective chart review was conducted for patients admitted to an intensive care unit (ICU) after cardiac arrest and treated with TH from January 2009 to June 2012 at two urban, university-affiliated, tertiary-care medical centres. Medications commonly used during TH were screened for association with significant ADRs (grade 3 or greater per Common Terminology Criteria for Adverse Events) using three published ADR detection instruments. A total of 229 patients were included, the majority being males with median age of 62 presenting with an out-of-hospital cardiac arrest in pulseless electrical activity or asystole. The most common comorbidities were hypertension, coronary artery disease, and diabetes mellitus. There were 670 possible ADRs and 69 probable ADRs identified. Of the 670 possible ADRs, propofol, fentanyl, and acetaminophen were the most common drugs associated with ADRs. Whereas fentanyl, insulin, and propofol were the most common drugs associated with a probable ADR. Patients were managed with TH for a median of 22 hours, with 38% of patients surviving to hospital discharge. Patients undergoing TH after cardiac arrest frequently experience possible adverse reactions associated with medications and the corresponding laboratory abnormalities are significant. There is a need for judicious use and close monitoring of drugs in the setting of TH until recommendations for dose adjustments are available to help prevent ADRs.

  9. Arresting Strategy Based on Dynamic Criminal Networks Changing over Time

    Directory of Open Access Journals (Sweden)

    Junqing Yuan


    Full Text Available We investigate a sequence of dynamic criminal networks on a time series based on the dynamic network analysis (DNA. According to the change of networks’ structure, networks’ variation trend is analyzed to forecast its future structure. Finally, an optimal arresting time and priority list are designed based on our analysis. Better results can be expected than that based on social network analysis (SNA.

  10. Distended Youth: Arrested Development in the Victorian Novel


    Dean, Tyler Michael


    Distended Youth: Arrested Development in the Victorian Novel examines the figure of the eternal child, the childlike adult and other aberrant permutations of the figure who has neither fully exited childhood nor entered adulthood, and the ways in which such figures are made Gothic as an expression of a peculiarly Victorian anxiety surrounding the oft elided or adumbrated transition from innocent and generative childhood to corrupt and destructive adult. It uses Dickens's Bleak House, Brontë's...

  11. Brain Gray Matter MRI Morphometry for Neuroprognostication After Cardiac Arrest. (United States)

    Silva, Stein; Peran, Patrice; Kerhuel, Lionel; Malagurski, Briguita; Chauveau, Nicolas; Bataille, Benoit; Lotterie, Jean Albert; Celsis, Pierre; Aubry, Florent; Citerio, Giuseppe; Jean, Betty; Chabanne, Russel; Perlbarg, Vincent; Velly, Lionel; Galanaud, Damien; Vanhaudenhuyse, Audrey; Fourcade, Olivier; Laureys, Steven; Puybasset, Louis


    We hypothesize that the combined use of MRI cortical thickness measurement and subcortical gray matter volumetry could provide an early and accurate in vivo assessment of the structural impact of cardiac arrest and therefore could be used for long-term neuroprognostication in this setting. Prospective cohort study. Five Intensive Critical Care Units affiliated to the University in Toulouse (France), Paris (France), Clermont-Ferrand (France), Liège (Belgium), and Monza (Italy). High-resolution anatomical T1-weighted images were acquired in 126 anoxic coma patients ("learning" sample) 16 ± 8 days after cardiac arrest and 70 matched controls. An additional sample of 18 anoxic coma patients, recruited in Toulouse, was used to test predictive model generalization ("test" sample). All patients were followed up 1 year after cardiac arrest. None. Cortical thickness was computed on the whole cortical ribbon, and deep gray matter volumetry was performed after automatic segmentation. Brain morphometric data were employed to create multivariate predictive models using learning machine techniques. Patients displayed significantly extensive cortical and subcortical brain volumes atrophy compared with controls. The accuracy of a predictive classifier, encompassing cortical and subcortical components, has a significant discriminative power (learning area under the curve = 0.87; test area under the curve = 0.96). The anatomical regions which volume changes were significantly related to patient's outcome were frontal cortex, posterior cingulate cortex, thalamus, putamen, pallidum, caudate, hippocampus, and brain stem. These findings are consistent with the hypothesis of pathologic disruption of a striatopallidal-thalamo-cortical mesocircuit induced by cardiac arrest and pave the way for the use of combined brain quantitative morphometry in this setting.

  12. Anaphylaxis with Latrodectus Antivenin Resulting in Cardiac Arrest


    Murphy, Christine M.; Hong, Jeannie J.; Beuhler, Michael C.


    Latrodectus mactans antivenin is a safe and effective therapy for severe black widow spider envenomations when given to most patients. We report a case of a 37-year-old male with a history of asthma that was given L. mactans antivenin for symptoms related to a black widow envenomation and developed a severe anaphylactic reaction resulting in cardiac arrest. When traditional therapies failed, the patient was given methylene blue for anaphylactic shock resulting in a 30-h period of hemodynamic ...

  13. Advances in crack-arrest technology for reactor pressure vessels

    International Nuclear Information System (INIS)

    Bass, B.R.; Pugh, C.E.


    The Heavy-Section Steel Technology (HSST) Program at the Oak Ridge National Laboratory (ORNL) under the sponsorship of the US Nuclear Regulatory Commission is continuing to improve the understanding of conditions that govern the initiation, rapid propagation, arrest, and ductile tearing of cracks in reactor pressure vessel (RPV) steels. This paper describes recent advances in a coordinated effort being conducted under the HSST Program by ORNL and several subcontracting groups to develop the crack-arrest data base and the analytical tools required to construct inelastic dynamic fracture models for RPV steels. Large-scale tests are being carried out to generate crack-arrest toughness data at temperatures approaching and above the onset of Charpy upper-shelf behavior. Small- and intermediate-size specimens subjected to static and dynamic loading are being developed and tested to provide additional fracture data for RPV steels. Viscoplastic effects are being included in dynamic fracture models and computer programs and their utility validated through analyses of data from carefully controlled experiments. Recent studies are described that examine convergence problems associated with energy-based fracture parameters in viscoplastic-dynamic fracture applications. Alternative techniques that have potential for achieving convergent solutions for fracture parameters in the context of viscoplastic-dynamic models are discussed. 46 refs., 15 figs., 3 tabs

  14. Initiation and arrest - two approaches to pressure vessel safety

    International Nuclear Information System (INIS)

    Brumovsky, M.; Filip, R.; Stepanek, S.


    The safety analysis is described of the reactor pressure vessel related to brittle fracture based on the fracture mechanics theory using two different approximations, i.e., the Crack Arrest Temperature (CAT) or Nil Ductility Temperature (NDT), and fracture toughness. The variation of CAT with stress was determined for different steel specimens of 120 to 200 mm in thickness. A diagram is shown of CAT variation with stress allowing the determination of crack arrest temperature for all types of commonly used steels independently of the NDT initial value. The diagram also shows that the difference between fracture transition elastic (FTE) and NDT depends on the type of material and determines the value of the ΔTsub(sigma) factor typical of the safety coefficient. The so-called fracture toughness reference value Ksub(IR) is recommended for the computation of pressure vessel criticality. Also shown is a defect analysis diagram which may be used for the calculation of pressure vessel safety prior to and during operation and which may also be used in making the decision on what crack sizes are critical, what cracks may be arrested and what cracks are likely to expand. The diagram is also important for the fact that it is material-independent and may be employed for the estimates of pre-operational and operational inspections and for pressure vessel life prediction. It is generally applicable to materials of greater thickness in the region where the validity of linear elastic fracture mechanics is guaranteed. (J.P.)

  15. Development of a data dictionary for the Strategies for Post Arrest Resuscitation Care (SPARC) network for post cardiac arrest research. (United States)

    Lin, Steve; Morrison, Laurie J; Brooks, Steven C


    The widely accepted Utstein style has standardized data collection and analysis in resuscitation and post resuscitation research. However, collection of many of these variables poses significant practical challenges. In addition, several important variables in post resuscitation research are missing. Our aim was to develop a comprehensive data dictionary and web-based data collection tool as part of the Strategies for Post Arrest Resuscitation Care (SPARC) Network project, which implemented a knowledge translation program for post cardiac arrest therapeutic hypothermia in 37 Ontario hospitals. A list of data variables was generated based on the current Utstein style, previous studies and expert opinion within our group of investigators. We developed a data dictionary by creating clear definitions and establishing abstraction instructions for each variable. The data dictionary was integrated into a web-based collection form allowing for interactive data entry. Two blinded investigators piloted the data collection tool, by performing a retrospective chart review. A total of 454 variables were included of which 400 were Utstein, 2 were adapted from existing studies and 52 were added to address missing elements. Kappa statistics for two outcome variables, survival to discharge and induction of therapeutic hypothermia were 0.86 and 0.64, respectively. This is the first attempt in the literature to develop a data dictionary as part of a standardized, pragmatic data collection tool for post cardiac arrest research patients. In addition, our dataset defined important variables that were previously missing. This data collection tool can serve as a reference for future trials in post cardiac arrest care. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. A Mutation in Mtap2 Is Associated with Arrest of Mammalian Spermatocytes before the First Meiotic Division

    Directory of Open Access Journals (Sweden)

    Fengyun Sun


    Full Text Available In spite of evolutionary conservation of meiosis, many of the genes that control mammalian meiosis are still unknown. We report here that the ENU-induced repro4 mutation, identified in a screen to uncover genes that control mouse meiosis, causes failure of spermatocytes to exit meiotic prophase I via the G2/MI transition. Major events of meiotic prophase I occurred normally in affected spermatocytes and known regulators of the meiotic G2/MI transition were present and functional. Deep sequencing of mutant DNA revealed a mutation located in an intron of the Mtap2 gene, encoding microtubule-associated protein 2, and levels of Mtap2 transcript were reduced in mutant testes. This evidence implicates MTAP2 as required directly or indirectly for completion of meiosis and normal spermatogenesis in mammals.

  17. Explaining discrepancies in arrest rates between Black and White male juveniles. (United States)

    Fite, Paula J; Wynn, Porche'; Pardini, Dustin A


    The authors investigated discrepancies in arrest rates between Black and White male juveniles by examining the role of early risk factors for arrest. Two hypotheses were evaluated: (a) Disproportionate minority arrest is due to increased exposure to early risk factors, and (b) a differential sensitivity to early risk factors contributes to disproportionate minority arrest. The study included 481 Black and White boys who were followed from childhood to early adulthood. A higher incidence of early risk factors accounted for racial differences related to any juvenile arrest, as well as differences in violence- and theft-related arrests. However, increased exposure to early risk factors did not explain race differences in drug-related arrests. Minimal support was found for the hypothesis that a differential sensitivity to risk factors accounts for disproportionate rate of minority male arrests. In sum, most racial discrepancies in juvenile male arrests were accounted for by an increased exposure to childhood risk factors. Specifically, Black boys were more likely to display early conduct problems and low academic achievement and experience poor parent-child communication, peer delinquency, and neighborhood problems, which increased their risk for juvenile arrest. (c) 2009 APA, all rights reserved.

  18. Growth arrest lines and intra-epiphyseal silhouettes: a case series. (United States)

    Kennedy, John W; Irwin, Greg J; Huntley, James S


    Growth arrest lines can develop within the skeleton after physiological stress or trauma. They are usually evident on radiographs as transverse lines in the metaphyses and have been used in fields from palaeontology to orthopaedics. This report consists of three cases, two of which describe growth arrest lines in an intra-epiphyseal site hitherto rarely documented, and a third demonstrating their clinical application. Case 1 describes a 9-year-old who suffered a knee hyperflexion injury requiring anterior cruciate ligament and posterior cruciate ligament reattachments. She subsequently developed a marked distal femoral intra-epiphyseal arrest silhouette, as well as metaphyseal arrest lines in the femur, tibia and fibula. Case 2 describes an 8-year-old who sustained a tibial spine fracture and underwent open reduction and internal fixation. Subsequent imaging shows a further example of femoral intra-epiphyseal arrest silhouette as well as tibia and fibula metaphyseal arrest lines. Case 3 describes a 10-year-old who sustained a distal tibia fracture which was managed with open reduction and internal fixation. Subsequently the metaphyseal growth arrest line was parallel to the physis, suggesting no growth arrest (a danger with such a fracture). This case series describes two examples of rarely described intra-epiphyseal growth arrest silhouettes and demonstrates the usefulness of arrest lines when assessing for growth plate damage.

  19. C.A.U.S.E.: Cardiac arrest ultra-sound exam--a better approach to managing patients in primary non-arrhythmogenic cardiac arrest. (United States)

    Hernandez, Caleb; Shuler, Klaus; Hannan, Hashibul; Sonyika, Chionesu; Likourezos, Antonios; Marshall, John


    Cardiac arrest is a condition frequently encountered by physicians in the hospital setting including the Emergency Department, Intensive Care Unit and medical/surgical wards. This paper reviews the current literature involving the use of ultrasound in resuscitation and proposes an algorithmic approach for the use of ultrasound during cardiac arrest. At present there is the need for a means of differentiating between various causes of cardiac arrest, which are not a direct result of a primary ventricular arrhythmia. Identifying the cause of pulseless electrical activity or asystole is important as the underlying cause is what guides management in such cases. This approach, incorporating ultrasound to manage cardiac arrest aids in the diagnosis of the most common and easily reversible causes of cardiac arrest not caused by primary ventricular arrhythmia, namely; severe hypovolemia, tension pneumothorax, cardiac tamponade, and massive pulmonary embolus. These four conditions are addressed in this paper using four accepted emergency ultrasound applications to be performed during resuscitation of a cardiac arrest patient with the aim of determining the underlying cause of a cardiac arrest. Identifying the underlying cause of cardiac arrest represents the one of the greatest challenges of managing patients with asystole or PEA and accurate determination has the potential to improve management by guiding therapeutic decisions. We include several clinical images demonstrating examples of cardiac tamponade, massive pulmonary embolus, and severe hypovolemia secondary to abdominal aortic aneurysm. In conclusion, this protocol has the potential to reduce the time required to determine the etiology of a cardiac arrest and thus decrease the time between arrest and appropriate therapy.

  20. Biomechanics of fall arrest using the upper extremity: age differences. (United States)

    Kim, Kyu-Jung; Ashton-Miller, James A


    This study tried to isolate critical biomechanical factors in fall arrests using the upper extremity during simulated forward falls. This study also attempted to find the differences in those factors between young and old age groups. The role of the upper extremity is not well defined despite its primary usage as a local shock absorber during fall impact. Comparative study in which two age groups underwent motion analysis.Methods. Ten healthy older males (mean age, 66.4 years) and 10 young males (mean age, 24.1 years) volunteered to perform self-initiated and cable-released falls at selected falling distances, while the joint motion and impact forces at the hand were recorded. Significant age differences were demonstrated in joint kinematics and impact force parameters at close distances. Excessive reflexive responses of the upper extremity in cable-released falls for the older adults resulted in 10-15 times higher peak impact forces and 2-3 times shorter body braking time than in self-initiated falls. Pre-impact activities of the upper extremity predispose the post-impact response during fall arrests. Suppressing excessive pre-impact reflexive activation of the arms could efficiently decrease the risk of fall-related injuries, which calls for securing sufficient arm movement time. Any fall prevention strategy that can increase arm movement time would be effective against injuries of the upper extremity during falling in the older adults. The findings will help to understand underlying mechanisms of fall arrest using the upper extremity for prevention of fall-related fractures.

  1. Symptomatic sinus arrest induced by acute marijuana use. (United States)

    Grieve-Eglin, Leandra; Haseeb, Sohaib; Wamboldt, Rachel; Baranchuk, Adrian


    Marijuana is considered a drug of low-toxicity, however its chronic and excessive use is regarded as a risk factor for general and cardiovascular health. Although investigated for therapeutic benefits, it can evoke electrocardiographic abnormalities in a dose-dependent manner. We report a case of a 54-year-old female who presented to the emergency department (ED) experiencing intermittent episodes of presyncope with tingling sensations around the left-side of the mouth and arm following acute inhalation of marijuana. Documented episodes of sinus arrest were noted.

  2. Adulthood animal abuse among men arrested for domestic violence. (United States)

    Febres, Jeniimarie; Brasfield, Hope; Shorey, Ryan C; Elmquist, Joanna; Ninnemann, Andrew; Schonbrun, Yael C; Temple, Jeff R; Recupero, Patricia R; Stuart, Gregory L


    Learning more about intimate partner violence (IPV), perpetrators could aid the development of more effective treatments. The prevalence of adulthood animal abuse (AAA) perpetration and its association with IPV perpetration, antisociality, and alcohol use in 307 men arrested for domestic violence were examined. Forty-one percent (n = 125) of the men committed at least one act of animal abuse since the age of 18, in contrast to the 1.5% prevalence rate reported by men in the general population. Controlling for antisociality and alcohol use, AAA showed a trend toward a significant association with physical and severe psychological IPV perpetration. © The Author(s) 2014.

  3. Delayed stenosis of the small intestine after cardiopulmonary arrest. (United States)

    Adachi, Seiji; Okuno, Mitsuru; Horibe, Yohei; Ono, Tomohiko; Goto, Naoe; Nakamura, Noriaki; Iwama, Midori; Yamauchi, Osamu; Saito, Koshiro


    A man in his 70s experienced cardiopulmonary arrest (CPA) due to acute myocardial infarction. He was resuscitated and treated with a multimodal approach, and he fortunately survived CPA without neurological damage. However, abdominal pain and vomiting occurred 45 days after the CPA. Small intestinal endoscopy showed pinhole-like stenosis of the ileum. Although balloon dilation was performed through the scope, his symptoms did not improve. Partial small bowel resection was eventually performed 139 days after the CPA. Pathological findings revealed ischemic changes in the mucosa at two spots. We speculate that an ischemic event occurred in the small bowel during CPA.

  4. [Cerebral oximetry in pulmonary thromboendarterectomy with circulatory arrest]. (United States)

    Catalán Escudero, P; González Román, A; Serra Ruiz, C N; Barbero Mielgo, M; García Fernández, J


    Pulmonary thromboendarterectomy is an uncommon procedure and should be performed with circulatory arrest. One of the major concerns is the postoperative central neurological injuries. Perioperative brain oxygen monitoring is advisable in this surgical procedure for the early detection of brain hypoperfusion episodes and their intensity as well as any other postoperative episodes that can deteriorate the neurological outcome. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  5. Brazilian production development of class 2 polymeric surge arresters for transmission line application

    Energy Technology Data Exchange (ETDEWEB)

    Dellallibera, Adriano A. [Industria Eletromecanica Balestro, Mogi Mirim, SP (Brazil)], E-mail:; Andrade, Antonio Donizetti de; Bezerra, Ana Cristina Guara; Duarte, Jose Vicente Pereira; Gois, Paulo Marcio Batista; Markiewicz, Rubens Leopoldo [Companhia Energetica de Minas Gerais (CEMIG), Belo Horizonte, MG (Brazil)], Emails:,,,,


    This paper shows the steeps of Brazilian class 2 ZnO lightning surge arrester development and production, aiming to attend the goal of CEMIG transmission lines performance improvement against lightning discharges action. The description of CEMIG transmission lines performance, before and after the ZnO lightning arresters installation, the necessity of use of ZnO lightning surge arrester, the prototypes manufacture, tests, problems and solutions are presented. (author)

  6. Characteristics and possibilities of software tool for metal-oxide surge arresters selection

    Directory of Open Access Journals (Sweden)

    Đorđević Dragan


    Full Text Available This paper presents a procedure for the selection of metal-oxide surge arresters based on the instructions given in the Siemens and ABB catalogues, respecting their differences and the characteristics and possibilities of the software tool. The software tool was developed during the preparation of a Master's thesis titled, 'Automation of Metal-Oxide Surge Arresters Selection'. An example is presented of the selection of metal-oxide surge arresters using the developed software tool.

  7. Interfacial Crack Arrest in Sandwich Panels with Embedded Crack Stoppers Subjected to Fatigue Loading

    DEFF Research Database (Denmark)

    Martakos, G.; Andreasen, J. H.; Berggreen, Christian


    A novel crack arresting device has been implemented in sandwich panels and tested using a special rig to apply out-of-plane loading on the sandwich panel face-sheets. Fatigue crack propagation was induced in the face-core interface of the sandwich panels which met the crack arrester. The effect...... of the embedded crack arresters was evaluated in terms of the achieved enhancement of the damage tolerance of the tested sandwich panels. A finite element (FE) model of the experimental setup was used for predicting propagation rates and direction of the crack growth. The FE simulation was based on the adoption...... as the overall performance of the crack arresters....

  8. Post-cardiorespiratory arrest beta-alpha coma: an unusual electroencephalographic phenomenon. (United States)

    Sarma, G R K; Kumar, A; Roy, A K; Pinheiro, L


    The presence of frontally-dominant alpha pattern in the EEG is common in patients with coma due to trauma, toxic-metabolic causes and following cardiorespiratory arrest. Diffuse beta activity following resuscitation after a cardiac arrest is not well recognized. We report a case of coma in a 3-year-old girl who had a cardiac arrest from which she was revived. Initial EEG showed diffuse beta activity, which later evolved to predominantly alpha activity. The possible mechanisms involved in the generation of such rhythms are discussed. Transition of EEG activity from faster to slower frequencies is suggested as an adverse prognostic factor in post-cardiorespiratory arrest coma.

  9. G2 phase arrest of cell cycle induced by ionizing radiation

    International Nuclear Information System (INIS)

    Liu Guangwei; Gong Shouliang


    The exposure of mammalian cells to X rays results in the prolongation of the cell cycle, including the delay or the arrest in G 1 , S and G 2 phase. The major function of G 1 arrest may be to eliminate the cells containing DNA damage and only occurs in the cells with wild type p53 function whereas G 2 arrest following ionizing radiation has been shown to be important in protecting the cells from death and occurs in all cells regardless of p53 status. So the study on G 2 phase arrest of the cell cycle induced by ionizing radiation has currently become a focus at radiobiological fields

  10. Sudden cardiac arrest and coexisting mitral valve prolapse: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Mohamed Ahmed


    Full Text Available The aetiology of sudden cardiac arrest can often be identified to underlying cardiac pathology. Mitral valve prolapse is a relatively common valvular pathology with symptoms manifesting with increasing severity of mitral regurgitation (MR. It is unusual for severe MR to be present without symptoms, and there is growing evidence that this subset of patients may be at increased risk of sudden cardiac arrest or death. The difficulty lies in identifying those patients at risk and applying measures that are appropriate to halting progression to cardiac arrest. This article examines the association of mitral valve prolapse with cardiac arrests, the underlying pathophysiological process and the strategies for identifying those at risk.

  11. Non-equilibrium theory of arrested spinodal decomposition

    Energy Technology Data Exchange (ETDEWEB)

    Olais-Govea, José Manuel; López-Flores, Leticia; Medina-Noyola, Magdaleno [Instituto de Física “Manuel Sandoval Vallarta,” Universidad Autónoma de San Luis Potosí, Álvaro Obregón 64, 78000 San Luis Potosí, SLP (Mexico)


    The non-equilibrium self-consistent generalized Langevin equation theory of irreversible relaxation [P. E. Ramŕez-González and M. Medina-Noyola, Phys. Rev. E 82, 061503 (2010); 82, 061504 (2010)] is applied to the description of the non-equilibrium processes involved in the spinodal decomposition of suddenly and deeply quenched simple liquids. For model liquids with hard-sphere plus attractive (Yukawa or square well) pair potential, the theory predicts that the spinodal curve, besides being the threshold of the thermodynamic stability of homogeneous states, is also the borderline between the regions of ergodic and non-ergodic homogeneous states. It also predicts that the high-density liquid-glass transition line, whose high-temperature limit corresponds to the well-known hard-sphere glass transition, at lower temperature intersects the spinodal curve and continues inside the spinodal region as a glass-glass transition line. Within the region bounded from below by this low-temperature glass-glass transition and from above by the spinodal dynamic arrest line, we can recognize two distinct domains with qualitatively different temperature dependence of various physical properties. We interpret these two domains as corresponding to full gas-liquid phase separation conditions and to the formation of physical gels by arrested spinodal decomposition. The resulting theoretical scenario is consistent with the corresponding experimental observations in a specific colloidal model system.

  12. Testing of long-flashover arresters designed for distribution lines

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira Filho, Orsino; Mello, Darcy Ramalho de; Oliveira, Gloria Suzana Gomes de [Centro de Pesquisas de Energia Eletrica (CEPEL), Rio de Janeiro, RJ (Brazil)], Emails:,,; Podporkin, Georgij; Wey, Acacio [Streamer Electric Company (Russian Federation)], E-mails:,


    Outages of overhead power lines due to lightning strokes are one of the main causes of shortages of electric supplies and economic losses of power utilities. Pole-top metal oxide arresters can protect distribution lines against induced over-voltages, but they can be destroyed in case of direct lightning stroke. Long Flashover Arresters (LFAs) have been developed and used successfully for this purpose and have no possibility of being destroyed because the current flows externally along its surface. Since field experience with 10 kV LFAs has been very successful, it was decided to work on developing 13.8 kV LFAs, considering that it is the predominant voltage level of overhead distribution lines in Brazil and other countries. The performance of LFA for quenching and dielectric tests has been investigated through laboratory tests under conditions that typically represent electrical energy distribution systems. Details about these tests and their results are presented in this paper. Information about their design and applications are also shortly presented (author)

  13. Electrophysiological Monitoring of Brain Injury and Recovery after Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Ruoxian Deng


    Full Text Available Reliable prognostic methods for cerebral functional outcome of post cardiac-arrest (CA patients are necessary, especially since therapeutic hypothermia (TH as a standard treatment. Traditional neurophysiological prognostic indicators, such as clinical examination and chemical biomarkers, may result in indecisive outcome predictions and do not directly reflect neuronal activity, though they have remained the mainstay of clinical prognosis. The most recent advances in electrophysiological methods—electroencephalography (EEG pattern, evoked potential (EP and cellular electrophysiological measurement—were developed to complement these deficiencies, and will be examined in this review article. EEG pattern (reactivity and continuity provides real-time and accurate information for early-stage (particularly in the first 24 h hypoxic-ischemic (HI brain injury patients with high sensitivity. However, the signal is easily affected by external stimuli, thus the measurements of EP should be combined with EEG background to validate the predicted neurologic functional result. Cellular electrophysiology, such as multi-unit activity (MUA and local field potentials (LFP, has strong potential for improving prognostication and therapy by offering additional neurophysiologic information to understand the underlying mechanisms of therapeutic methods. Electrophysiology provides reliable and precise prognostication on both global and cellular levels secondary to cerebral injury in cardiac arrest patients treated with TH.

  14. Variation in Out-of-Hospital Cardiac Arrest Management

    Directory of Open Access Journals (Sweden)

    Jason M. Jones


    Full Text Available Objective. To evaluate variation in airway management strategies in one suburban emergency medical services system treating patients experiencing out-of-hospital cardiac arrest (OHCA. Method. Retrospective chart review of all adult OHCA resuscitation during a 13-month period, specifically comparing airway management decisions. Results. Paramedics demonstrated considerable variation in their approaches to airway management. Approximately half of all OHCA patients received more than one airway management attempt (38/77 [49%], and one-quarter underwent three or more attempts (25/77 [25%]. One-third of patients arrived at the emergency department with a different airway device than initially selected (25/77 [32%]. Conclusion. This study confirmed our hypothesis that paramedics’ selection of ventilation strategies in cardiac arrest varies considerably. This observation raises concern because airway management diverts time and energy from interventions known to improve outcomes in OHCA management, such as cardiopulmonary resuscitation and defibrillation. More research is needed to identify more focused airway management strategies for prehospital care providers.

  15. In-hospital pediatric cardiac arrest in Honduras. (United States)

    Matamoros, Martha; Rodriguez, Roger; Callejas, Allison; Carranza, Douglas; Zeron, Hilda; Sánchez, Carlos; Del Castillo, Jimena; López-Herce, Jesús


    The objective of this study was to analyze the characteristic and the prognostic factors of in-hospital pediatric cardiac arrest (CA) in a public hospital Honduras. A prospective observational study was performed on pediatric in-hospital CA as a part of a multicenter international study. One hundred forty-six children were studied. The primary end point was survival at hospital discharge. Univariate and multivariate logistic regression analyses were performed to assess the influence of each factor on mortality. Cardiac arrest occurred in the emergency department in 66.9%. Respiratory diseases and sepsis were predominant causes of CA. Return of spontaneous circulation was achieved in 60% of patients, and 22.6% survived to hospital discharge. The factors related with mortality were nonrespiratory cause of CA (odds ratio [OR], 2.55; P = 0.045), adrenaline administration (OR, 4.96; P = 0.008), and a duration of cardiopulmonary resuscitation more than 10 minutes (OR, 3.40; P = 0.012). In-hospital CA in children in a developing country has low survival. Patients with nonrespiratory causes and those who need adrenaline administration and prolonged resuscitation had worse prognosis.

  16. Prescription Monitoring Program Trends Among Individuals Arrested in Maine for Trafficking Prescription Drugs in 2014. (United States)

    McCall, Kenneth; Nichols, Stephanie D; Holt, Christina; Ochs, Leslie; Cattabriga, Gary; Tu, Chunhao


    To evaluate controlled substance prescribing trends available in the Maine Prescription Monitoring Program (PMP) among individuals arrested for prescription drug "trafficking." The demographic characteristics of the individuals who had matching prescription records in the PMP within 90 days of the arrest were identified. A population-based, retrospective cohort study using data from the Maine Diversion Alert Program (DAP) and the Maine PMP. The study population consisted of persons arrested for trafficking prescription drugs in Maine during the 2014 calendar year from January 1 to December 31. There were 594 trafficking arrests reported by the Maine DAP in 2014. The study population consisted of the 235 persons (40%) with arrests involving controlled prescription medications. The mean age of these persons was 33 years (range 18-77 yrs), and 156 (66%) were male. Arrests involved 154 prescription opioids (65%), seven stimulants (3%), seven benzodiazepines (3%), and 77 unspecified controlled prescription drugs (33%). A minority of individuals (n=57, 24%) had a prescription record in the PMP that matched the substance involved in the arrest. Only one person with matching PMP and arrest records utilized ≥ 5 prescribers, while none used ≥ 5 pharmacies within 90 days before the arrest. Payment methods for matching prescriptions were commercial insurance (n=28, 49%), Medicaid (n=19, 33%), Medicare (n=5, 9%), and cash (n=5, 9%). The majority (76%) of persons arrested for prescription drug trafficking did not have PMP records and did not directly obtain the diverted medication from a licensed pharmacy. Traditional red flags, like cash payment and using multiple prescribers or pharmacies, were uncommon. Therefore, arrest records for diversion and PMPs are distinct and complementary tools for identifying individuals at risk for substance misuse. © 2016 Pharmacotherapy Publications, Inc.

  17. Survival of cardiorespiratory arrest after coronary artery bypass grafting or aortic valve surgery. (United States)

    Ngaage, Dumbor L; Cowen, Michael E


    Study objectives were to (1) report the clinical profile of and outcome for patients who experience a cardiorespiratory arrest after coronary artery bypass grafting or aortic valve replacement, and (2) identify factors associated with improved probability of survival. We identified 108 consecutive patients who had cardiorespiratory arrest after coronary artery bypass grafting or aortic valve replacement between April 1999 and June 2008. We studied the characteristics of arrests and survivors, and performed a multivariate logistic analysis to determine features associated with survival to hospital discharge. Cardiac arrest (n = 86) was more common than respiratory arrest (n = 13; unknown cause, n = 9). Cardiorespiratory arrest occurred with decreasing frequency from the day of surgery. Ventricular fibrillation or tachycardia was the dominant mechanism of cardiac arrest (70% versus 17% for asystole versus 13% for pulseless electrical activity), and the principal causes were postoperative myocardial infarction (n = 46; 53%) and tamponade or bleeding (n = 21; 24%). Resternotomy was performed in 45 patients (52%), cardiopulmonary bypass reinstituted in 14 (16%), and additional grafts constructed in 5 (6%). The causes of respiratory arrest were mainly pulmonary (n = 8) and neurologic (n = 5). Survival to hospital discharge was better for respiratory arrest (69%) than for cardiac arrest (50%). Older age, ejection fraction less than 0.30, and postoperative myocardial infarction decreased the probability of survival. Ventricular fibrillation or tachycardia was the most common mechanism, and myocardial infarction, the predominant precipitating cause of cardiac arrest after coronary artery bypass grafting or aortic valve replacement. Despite aggressive resuscitation, outcome is poor. Young patients with good left ventricular function had a better probability of survival if they did not suffer a postoperative myocardial infarction.

  18. Epidemiology and outcomes of cardiac arrest among children with Down Syndrome: a multicenter analysis. (United States)

    Padiyath, Asif; Rettiganti, Mallikarjuna; Gossett, Jeffrey M; Tadphale, Sachin D; Garcia, Xiomara; Seib, Paul M; Gupta, Punkaj


    With the increasing prevalence of Down Syndrome, it is unknown if children with Down Syndrome are associated with increased incidence of cardiac arrest and poor outcomes after cardiac arrest. The objective of this study was to evaluate the epidemiology of cardiac arrest and mortality after cardiac arrest among critically ill children with and without Down Syndrome. Patients ≤18 years admitted at a Pediatric Health Information Systems (PHIS) participating Intensive Care Unit were included (2004-2014). Multivariable logistic regression models were fitted to evaluate association of Down Syndrome with study outcomes after adjusting for patient and center characteristics. A total of 849,250 patients from 44 centers were included. Of the 25,143 patients with Down Syndrome, cardiac arrest was noted among 568 (2.3%) patients with an associated mortality at hospital discharge of 248 (43.6%) patients. In contrast, of the 824,107 patients without Down Syndrome, cardiac arrest was noted among 15,822 (1.9%) patients with an associated mortality at hospital discharge of 7775 (49.1%) patients. In adjusted models, patients with Down Syndrome had a higher likelihood of having cardiac arrest as compared to patients without Down Syndrome (with vs. without Down, OR: 1.14, 95% CI: 1.03-1.25, P=0.01). Despite having a higher likelihood of cardiac arrest, patients with Down Syndrome were associated with a lower mortality after cardiac arrest (OR: 0.78, 95% CI: 0.63-0.96, P=0.02). Both incidence of cardiac arrest, and mortality at hospital discharge in those with cardiac arrest vary substantially in children with and without Down Syndrome.

  19. Organisation of in-hospital cardiac arrest teams - a nationwide study. (United States)

    Lauridsen, Kasper Glerup; Schmidt, Anders Sjørslev; Adelborg, Kasper; Løfgren, Bo


    In-hospital cardiac arrests are treated by a team of health care providers. Improving team performance may increase survival. Currently, no international standards for cardiac arrest teams exist in terms of member composition and allocation of tasks. To describe the composition of in-hospital cardiac arrest teams and review pre-arrest allocation of tasks. A nationwide cross-sectional study was performed. Data on cardiac arrest teams and pre-arrest allocation of tasks were collected from protocols on resuscitation required for hospital accreditation in Denmark. Additional data were collected through telephone interviews and email correspondence. Psychiatric hospitals and hospitals serving outpatients only were excluded. Data on the cardiac arrest team were available from 44 of 47 hospitals. The median team size was 5 (25th percentile; 75th percentile: 4; 6) members. Teams included a nurse anaesthetist (100%), a medical house officer (82%), an orderly (73%), an anaesthesiology house officer (64%) and a medical assistant (20%). Less likely to participate was a cardiology house officer (23%) or a cardiology specialist registrar (5%). Overall, a specialist registrar was represented on 20% of teams and 20% of cardiac arrest teams had a different team composition during nights and weekends. In total, 41% of teams did not define a team leader pre-arrest, and the majority of the teams did not define the tasks of the remaining team members. In Denmark, there are major differences among cardiac arrest teams. This includes team size, profession of team members, medical specialty and seniority of the physicians. Nearly half of the hospitals do not define a cardiac arrest team leader and the majority do not define the tasks of the remaining team members. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Induced hypothermia after cardiac arrest in trauma patients: a case series. (United States)

    Tuma, Mazin A; Stansbury, Lynn G; Stein, Deborah M; McQuillan, Karen A; Scalea, Thomas M


    Induced hypothermia after cardiac arrest is an accepted neuroprotective strategy. However, its role in cardiac arrest during acute trauma care is not yet defined. To characterize recent experience with this technique at our center, we undertook a detailed chart review of acute trauma patients managed with induced hypothermia after cardiac arrest. From Trauma Registry records, we identified all adult patients (older than 17 years) admitted to our Level I trauma center from July 1, 2008, through June 30, 2010, who experienced cardiac arrest during acute trauma care and were managed via our induced hypothermia protocol. This requires maintenance of core body temperature between 32°C and 34°C for 24 hours after arrest. Patient clinical records were then reviewed for selected factors. Six acute trauma patients (3 male and 3 female; median age, 53 years) with cardiac arrest managed per protocol were identified. All injuries were due to blunt impact, and five of six injuries were motor-vehicle-associated. Median Injury Severity Score was 27; median prearrest Glasgow Coma Scale (GCS) score was 15. One patient arrested prehospital and the other 5 in-hospital. Median duration of arrest was 8 minutes. All were comatose after arrest. One death occurred, in the patient with a prehospital cardiac arrest. Two patients were discharged to chronic care facilities with GCS11-tracheostomy; three were discharged to active rehabilitation care facilities with GCS score of 14 to 15. There were no obvious complications related to cooling. Mild induced hypothermia can be beneficial in a selected group of trauma patients after cardiac arrest. Prospective trials are needed to explore the effects of targeted temperature management on coagulation in this patient group.

  1. Cell cycle age dependence for radiation-induced G2 arrest: evidence for time-dependent repair

    International Nuclear Information System (INIS)

    Rowley, R.


    Exponentially growing eucaryotic cells, irradiated in interphase, are delayed in progression to mitosis chiefly by arrest in G 2 . The sensitivity of Chinese hamster ovary cells to G 2 arrest induction by X rays increases through the cell cycle, up to the X-ray transition point (TP) in G 2 . This age response can be explained by cell cycle age-dependent changes in susceptibility of the target(s) for G 2 arrest and/or by changes in capability for postirradiation recovery from G 2 arrest damage. Discrimination between sensitivity changes and repair phenomena is possible only if the level of G 2 arrest-causing damage sustained by a cell at the time of irradiation and the level ultimately expressed as arrest can be determined. The ability of caffeine to ameliorate radiation-induced G 2 arrest, while inhibiting repair of G 2 arrest-causing damage makes such an analysis possible. In the presence of caffeine, progression of irradiated cells was relatively unperturbed, but on caffeine removal, G 2 arrest was expressed. The duration of G 2 arrest was independent of the length of the prior caffeine exposure. This finding indicates that the target for G 2 arrest induction is present throughout the cell cycle and that the level of G 2 arrest damage incurred is initially constant for all cell cycle phases. The data are consistent with the existence of a time-dependent recovery mechanism to explain the age dependence for radiation induction of G 2 arrest

  2. The Influence of Peer and Educational Variables on Arrest Status among At-Risk Males. (United States)

    Bullis, Michael; Walker, Hill M.; Stieber, Steve


    A study examined the predictive power of selected social and academic variables regarding the arrest frequency for 11th-grade boys who seven years earlier had been judged to be at risk of developing antisocial behavior patterns. Antisocial measures on which participants scored higher were associated with more frequent arrests. (Author/CR)

  3. 38 CFR 3.375 - Determination of inactivity (complete arrest) in tuberculosis. (United States)


    ... inactivity (complete arrest) in tuberculosis. 3.375 Section 3.375 Pensions, Bonuses, and Veterans' Relief...) in tuberculosis. (a) Pulmonary tuberculosis. A veteran shown to have had pulmonary tuberculosis will...) Nonpulmonary disease. Determination of complete arrest of nonpulmonary tuberculosis requires absence of...

  4. 46 CFR 32.20-10 - Flame arresters-TB/ALL. (United States)


    ... 46 Shipping 1 2010-10-01 2010-10-01 false Flame arresters-TB/ALL. 32.20-10 Section 32.20-10 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS SPECIAL EQUIPMENT, MACHINERY, AND HULL REQUIREMENTS Equipment Installations § 32.20-10 Flame arresters—TB/ALL. Flame arresters must be of a type and...

  5. 46 CFR 30.10-23 - Flame arrester-TB/ALL. (United States)


    ... 46 Shipping 1 2010-10-01 2010-10-01 false Flame arrester-TB/ALL. 30.10-23 Section 30.10-23 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS GENERAL PROVISIONS Definitions § 30.10-23 Flame arrester—TB/ALL. The term flame arrester means any device or assembly of a cellular, tubular...

  6. 46 CFR 30.10-63 - Spark arrester-TB/ALL. (United States)


    ... 46 Shipping 1 2010-10-01 2010-10-01 false Spark arrester-TB/ALL. 30.10-63 Section 30.10-63 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY TANK VESSELS GENERAL PROVISIONS Definitions § 30.10-63 Spark arrester—TB/ALL. The term spark arrester means any device, assembly, or method of a...

  7. Cardiac arrest in pregnancy: Case report and review of the literature ...

    African Journals Online (AJOL)

    Cardiac arrest in pregnancy is a rare event, and resuscitation of the pregnant patient is complicated by the impact on resuscitative measures of the normal physiological changes of pregnancy. A case of successful resuscitation of a pregnant patient with a cardiac arrest and a normal neurocognitive outcome is reported.

  8. Out of hospital thoracotomy for cardiac arrest after penetrating thoracic trauma

    NARCIS (Netherlands)

    M.G. van Vledder (Mark); O.J.F. van Waes (Oscar); Kooij, F.O. (Fabian O.); Peters, J.H. (Joost H.); E.M.M. van Lieshout (Esther); M.H.J. Verhofstad (Michiel)


    textabstractIntroduction: Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and

  9. Out of hospital thoracotomy for cardiac arrest after penetrating thoracic trauma

    NARCIS (Netherlands)

    van Vledder, Mark G.; van Waes, Oscar J. F.; Kooij, Fabian O.; Peters, Joost H.; van Lieshout, Esther M. M.; Verhofstad, Michael H. J.


    Emergency department thoracotomy is an established procedure for cardiac arrest in patients suffering from penetrating thoracic trauma and yields relatively high survival rates (up to 21%) in patients with cardiac tamponade. To minimize the delay between arrest and thoracotomy, some have advocated

  10. Comparison of analysis and experimental data for a unique crack arrest specimen

    International Nuclear Information System (INIS)

    Ayres, D.J.; Fabi, R.J.; Schonenberg, R.Y.; Norris, D.M.


    A new fracture test specimen has been developed to study crack extension and arrest in nuclear reactor vessel steels subject to stress-intensity factor and toughness gradients similar to those in postulated pressurized thermal shock situations. A summary of the results of all the tests performed is presented to illustrate the range of crack arrest and crack reinitiation conditions observed. One test of this specimen with the corresponding stress analysis is described in detail. During this test the crack initiated, extended, arrested, reinitiated, extended again, and reached a final arrest. Comparison of detailed dynamic elastic-plastic finite-element analyses and dynamic strain and displacement measurements of the crack extension, arrest, and reinitiation events, combined with topographic analysis of the future surfaces, has led to a new understanding of the crack extension and arrest process. The results of the tests demonstrate crack arrest in rising stress-intensity field at near-upper-shelf temperature conditions and show that the toughness required for arrest is lower than would be predicted by the analysis procedures usually employed for pressurized thermal shock evaluations

  11. A Summary and Analysis of Warrantless Arrest Statutes for Domestic Violence in the United States (United States)

    Zeoli, April M.; Norris, Alexis; Brenner, Hannah


    In the United States, all 50 states and the District of Columbia have enacted statutes that allow police officers to make warrantless arrests for domestic violence given probable cause; however, state laws differ from one another in multiple, important ways. Research on domestic violence warrantless arrest laws rarely describe them as anything…

  12. Program Completion and Re-Arrest in a Batterer Intervention System (United States)

    Bennett, Larry W.; Stoops, Charles; Call, Christine; Flett, Heather


    Objective: The authors examine the effects of batterer intervention program (BIP) completion on domestic violence re-arrest in an urban system of 30 BIPs with a common set of state standards, common program completion criteria, and centralized criminal justice supervision. Method: 899 men arrested for domestic violence were assessed and completed…

  13. 28 CFR 50.5 - Notification of Consular Officers upon the arrest of foreign nationals. (United States)


    ... the arrest of foreign nationals. 50.5 Section 50.5 Judicial Administration DEPARTMENT OF JUSTICE... nationals of foreign countries are arrested by officers of this Department on charges of criminal violations. It conforms to practice under international law and in particular implements obligations undertaken...

  14. How long do offenders escape arrest? Using DNA traces to analyse when serial offenders are caught

    NARCIS (Netherlands)

    Lammers, M.; Bernasco, W.; Elffers, H.


    Keywords:clearance;serial offenders;DNA traces;unidentified offenders;Cox proportional hazards model;hazard ratio Abstract Why is it that some serial offenders are arrested quickly and others only after a long period, or never at all? What characterises offenders who continue to escape arrest

  15. 39 CFR 230.4 - Arrest and investigative powers of criminal investigators. (United States)


    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Arrest and investigative powers of criminal investigators. 230.4 Section 230.4 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND ADMINISTRATION OFFICE OF INSPECTOR GENERAL General Policy and Authority § 230.4 Arrest and investigative powers of...

  16. Survival in patients without acute ST elevation after cardiac arrest and association with early coronary angiography

    DEFF Research Database (Denmark)

    Dankiewicz, J; Nielsen, N; Annborn, M


    PURPOSE: To investigate whether early coronary angiography (CAG) after out-of-hospital cardiac arrest of a presumed cardiac cause is associated with improved outcomes in patients without acute ST elevation. METHODS: The target temperature management after out-of-hospital cardiac arrest (TTM) tria...

  17. Gender Differences in Drug Use, Sexually Transmitted Diseases, and Risky Sexual Behavior among Arrested Youths (United States)

    Dembo, Richard; Belenko, Steven; Childs, Kristina; Greenbaum, Paul E.; Wareham, Jennifer


    Data was collected on arrested youths processed at a centralized intake facility, including youths released back to the community and those placed in secure detention. This article reports the results of a test of a structural model involving newly arrested male and female youths' sexually transmitted diseases (STD) test results, urine analysis…

  18. 30 CFR 77.508 - Lightning arresters, ungrounded and exposed power conductors and telephone wires. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Lightning arresters, ungrounded and exposed... AND SURFACE WORK AREAS OF UNDERGROUND COAL MINES Electrical Equipment-General § 77.508 Lightning... conductors and telephone wires shall be equipped with suitable lightning arresters which are adequately...

  19. Beneficial effects of sevoflurane and desflurane against myocardial reperfusion injury after cardioplegic arrest

    NARCIS (Netherlands)

    Preckel, B.; Thämer, V.; Schlack, W.


    PURPOSE: To determine whether sevoflurane or desflurane offer additional protective effects against myocardial reperfusion injury after protecting the heart against the ischemic injury by cardioplegic arrest. METHODS: Isolated rat hearts in a Langendorff-preparation (n = 9) were arrested by infusion

  20. Mental Condition and Ventricular Size in Arrested Hydrocephalus: an Analysis of 29 Shunt‐independent Children

    NARCIS (Netherlands)



    textabstractMeasurement of the diameter of the ventricular system, in a series of 29 patients with arrested hydrocephalus who had become shunt‐independent, showed that enlargement of the ventricles does not necessarily play a part in the arrest of hydrocephalus, for in many of these cases the

  1. Same-Sex and Race-Based Disparities in Statutory Rape Arrests. (United States)

    Chaffin, Mark; Chenoweth, Stephanie; Letourneau, Elizabeth J


    This study tests a liberation hypothesis for statutory rape incidents, specifically that there may be same-sex and race/ethnicity arrest disparities among statutory rape incidents and that these will be greater among statutory rape than among forcible sex crime incidents. 26,726 reported incidents of statutory rape as defined under state statutes and 96,474 forcible sex crime incidents were extracted from National Incident-Based Reporting System data sets. Arrest outcomes were tested using multilevel modeling. Same-sex statutory rape pairings were rare but had much higher arrest odds. A victim-offender romantic relationship amplified arrest odds for same-sex pairings, but damped arrest odds for male-on-female pairings. Same-sex disparities were larger among statutory than among forcible incidents. Female-on-male incidents had uniformly lower arrest odds. Race/ethnicity effects were smaller than gender effects and more complexly patterned. The findings support the liberation hypothesis for same-sex statutory rape arrest disparities, particularly among same-sex romantic pairings. Support for race/ethnicity-based arrest disparities was limited and mixed. © The Author(s) 2014.

  2. 30 CFR 77.508-1 - Lightning arresters; wires entering buildings. (United States)


    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Lightning arresters; wires entering buildings... buildings. Lightning arresters protecting exposed telephone wires entering buildings shall be provided at the point where each such telephone wire enters the building. ...

  3. How eggs arrest at metaphase II: MPF stabilisation plus APC/C inhibition equals Cytostatic Factor

    Directory of Open Access Journals (Sweden)

    Jones Keith T


    Full Text Available Abstract Oocytes from higher chordates, including man and nearly all mammals, arrest at metaphase of the second meiotic division before fertilization. This arrest is due to an activity that has been termed 'Cytostatic Factor'. Cytostatic Factor maintains arrest through preventing loss in Maturation-Promoting Factor (MPF; CDK1/cyclin B. Physiologically, Cytostatic Factor – induced metaphase arrest is only broken by a Ca2+ rise initiated by the fertilizing sperm and results in degradation of cyclin B, the regulatory subunit of MPF through the Anaphase-Promoting Complex/Cyclosome (APC/C. Arrest at metaphase II may therefore be viewed as being maintained by inhibition of the APC/C, and Cytostatic Factor as being one or more pathways, one of which inhibits the APC/C, consorting in the preservation of MPF activity. Many studies over several years have implicated the c-Mos/MEK/MAPK pathway in the metaphase arrest of the two most widely studied vertebrates, frog and mouse. Murine downstream components of this cascade are not known but in frog involve members of the spindle assembly checkpoint, which act to inhibit the APC/C. Interesting these downstream components appear not to be involved in the arrest of mouse eggs, suggesting a lack of conservation with respect to c-Mos targets. However, the recent discovery of Emi2 as an egg specific APC/C inhibitor whose degradation is Ca2+ dependent has greatly increased our understanding of MetII arrest. Emi2 is involved in both the establishment and maintenance of metaphase II arrest in frog and mouse suggesting a conservation of metaphase II arrest. Its identity as the physiologically relevant APC/C inhibitor involved in Cytostatic Factor arrest prompted us to re-evaluate the role of the c-Mos pathway in metaphase II arrest. This review presents a model of Cytostatic Factor arrest, which is primarily induced by Emi2 mediated APC/C inhibition but which also requires the c-Mos pathway to set MPF levels within

  4. Current practice in out-of-hospital cardiac arrest management

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Dobreanu, Dan; Pison, Laurent


    AIMS: The purpose of this EP wire is to examine clinical practice in the field of out-of-hospital cardiac arrest (OHCA) management, with special focus on in-hospital diagnostic and therapeutic strategies. METHODS AND RESULTS: Fifty-three European centres, all members of the EHRA-EP Research network......, completed the questions of the survey. A dedicated strategy for OHCA management is active in 85% of the centres. Shockable tachyarrhythmias such as initial OHCA rhythm are reported in >70% of the patients in 64% of the centres. In-hospital therapeutic hypothermia was applied in >50% of the patients in 53...... management strategy, including coronary angiography/PCI and implantable cardioverter defibrillator therapy, while therapeutic hypothermia appears to be underused....

  5. Thermal shock induced crack arrest of two low alloy steels

    International Nuclear Information System (INIS)

    Di Fant, M.; Genty, A.; Pineau, A.


    Tests were performed on a C-Mn-Nb steel (E36) and a C-Mn-Ni-Mo steel (A508) to determine the fracture toughness either at crack initiation, K Ic , or at crack arrest, K Ia , under a very severe thermal shock such as rupture of a PWR primary coolant circuit. Experiments were carried out either on small discs (thickness 19 mm) or on larger cylinders (height: 220 mm) with an inner diameter of 46 or 50 mm and an external diameter of 150 mm. Finite element method calculations were performed to determine the variations of the hoop stress and those of the stress intensity factor across the wall thickness. Results obtained on both materials are given. It is shown that the BEREMIN model for cleavage fracture takes well account of crack initiation and size effect [fr

  6. First permanent molar root development arrest associated with compound odontoma. (United States)

    Gunda, Sachin A; Patil, Anil; Varekar, Aniruddha


    Trauma or infection to the primary tooth may have deleterious effects on the underlying developing tooth buds. Anatomically the root apices of primary teeth are in close proximity to the developing permanent tooth buds; hence spread of infection originating from pulp necrosis of primary tooth may not only affect the underlying tooth bud but may also affect the adjacent tooth buds. The extent of malformation depends on the developmental stage of tooth or the age of patient. Presented here is a rare case of complete arrest of maxillary first permanent molar root growth due to spread of periapical infection originating from second primary molar leading to failure of its eruption and finally extraction. Histopathlogical analysis revealed compound odontoma associated with maxillary first permanent molar.

  7. Opiate Withdrawal Complicated by Tetany and Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Irfanali R. Kugasia


    Full Text Available Patients with symptoms of opiate withdrawal, after the administration of opiate antagonist by paramedics, are a common presentation in the emergency department of hospitals. Though most of opiate withdrawal symptoms are benign, rarely they can become life threatening. This case highlights how a benign opiate withdrawal symptom of hyperventilation led to severe respiratory alkalosis that degenerated into tetany and cardiac arrest. Though this patient was successfully resuscitated, it is imperative that severe withdrawal symptoms are timely identified and immediate steps are taken to prevent catastrophes. An easier way to reverse the severe opiate withdrawal symptom would be with either low dose methadone or partial opiate agonists like buprenorphine. However, if severe acid-base disorder is identified, it would be safer to electively intubate these patients for better control of their respiratory and acid-base status.

  8. Central diabetes insipidus following cardiopulmonary arrest in a dog. (United States)

    Bellis, Tara; Daly, Meredith; Davidson, Benjamin


    To describe a clinical case of transient central diabetes insipidus (CDI) occurring post cardiopulmonary arrest (CPA) in a dog. An 8-week-old dog presented for intensive care after successful resuscitation following CPA. The patient exhibited neurologic deficits at initial presentation and over the following days developed marked polyuria, isosthenuria, and low urine osmolality. Treatment with synthetic vasopressin resulted in a reduction in urine output, increase in urine specific gravity (>50%), and increase in urine osmolality, suggesting a diagnosis of partial CDI. Clinical signs resolved over the following weeks and treatment was discontinued. CPA has been described as a cause of ischemic injury to the pituitary gland resulting in CDI in people. To the authors' knowledge, this is the first report of a dog developing transient partial CDI following CPA and successful resuscitation. © Veterinary Emergency and Critical Care Society 2015.

  9. [Emphysematous Pyelonephritis with Cardio-Pulmonary Arrest : A Case Report]. (United States)

    Yamamichi, Gaku; Tsutahara, Koichi; Kuribayashi, Sohei; Kawamura, Masataka; Nakano, Kosuke; Kishimoto, Nozomu; Tanigawa, Go; Matsushima, Asako; Fujimi, Satoshi; Takao, Tetsuya; Yamaguchi, Seiji


    A 40-year-old woman withuntreated type II diabetes mellitus was discovered withcardiopulmonary arrest in her room. On admission, she had ventricular fibrillation. After cardiopulmonary resuscitation, her own pulse restarted. The plasma glucose was 722 mg/dl and venous PH was 6.704. Abdominal computed tomography revealed gas within the parenchyma of the left kidney. We diagnosed her with emphysematous pyelonephritis and conducted emergency nephrectomy. Urinary and blood cultures were positive for Escherichia coli. Antibiotic therapy was initiated with doripenem and she was restrictively treated with intravenous insulin to control her plasma glucose. On the 8th day of hospital stay, she underwent resection of the small intestine because of necrosis. After multidisciplinary therapy, she was discharged with complete resolution of the infection.

  10. Anaphylaxis with Latrodectus antivenin resulting in cardiac arrest. (United States)

    Murphy, Christine M; Hong, Jeannie J; Beuhler, Michael C


    Latrodectus mactans antivenin is a safe and effective therapy for severe black widow spider envenomations when given to most patients. We report a case of a 37-year-old male with a history of asthma that was given L. mactans antivenin for symptoms related to a black widow envenomation and developed a severe anaphylactic reaction resulting in cardiac arrest. When traditional therapies failed, the patient was given methylene blue for anaphylactic shock resulting in a 30-h period of hemodynamic stability. Despite initial resuscitation, the patient ultimately died 40 h after presentation. Under the right circumstances, L. mactans antivenin remains a safe and effective therapy for severe black widow envenomations. However, anaphylaxis is a risk for those receiving this therapy, even when the antivenin is diluted and given as an infusion. We report the first death related to diluted L. mactans antivenin given as an infusion.

  11. Partners in Crime in the Setting of Recurring Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Lida P. Papavasileiou


    Full Text Available No previous reports are available about the potential dramatic effects resulting from the combination of acquired long QT interval not associated to bradycardia and myocardial ischemia. We report the case of a man that during acute necrotic pancreatitis presented QT interval prolongation without bradycardia, TdP, and two episodes of cardiac arrest. A coronary angiogram revealed a subocclusive stenosis of left anterior descending coronary artery, treated with a percutaneous coronary intervention. After myocardial revascularization, even in presence of long QT interval, no arrhythmic events occurred suggesting the key role of myocardial ischemia in triggering TdP in acquired long QT even without bradycardia. ECG performed six months later, after complete recovery from pancreatitis, showed a normal QT interval.

  12. Partners in crime in the setting of recurring cardiac arrest. (United States)

    Papavasileiou, Lida P; Forleo, Giovanni B; Santini, Luca; Martuscelli, Eugenio; Romeo, Francesco


    No previous reports are available about the potential dramatic effects resulting from the combination of acquired long QT interval not associated to bradycardia and myocardial ischemia. We report the case of a man that during acute necrotic pancreatitis presented QT interval prolongation without bradycardia, TdP, and two episodes of cardiac arrest. A coronary angiogram revealed a subocclusive stenosis of left anterior descending coronary artery, treated with a percutaneous coronary intervention. After myocardial revascularization, even in presence of long QT interval, no arrhythmic events occurred suggesting the key role of myocardial ischemia in triggering TdP in acquired long QT even without bradycardia. ECG performed six months later, after complete recovery from pancreatitis, showed a normal QT interval.

  13. A Unique Case of Cardiac Arrest following K2 Abuse

    Directory of Open Access Journals (Sweden)

    Saif Ibrahim


    Full Text Available Sudden cardiac death (SCD accounts for up to 450,000 deaths every year in the United States (Zipes et al. (2006. Most cases of sudden cardiac death occur in subjects with no prior history of heart disease (Myerburg et al. (1998. The incidence of sudden death in a general population has been shown to increase contemporaneously with substance abuse (Phillips et al. (1999. The causative association of sudden death with cocaine, methadone, and volatile agents is well established (Adgey et al. (1995 and Isner et al. (1986. We describe a case of out-of-hospital cardiac arrest temporally related to abuse of the synthetic cannabinoid street drug known as K2. To our knowledge, there are no previously documented cases of sudden cardiac death associated with synthetic cannabinoids although they have been linked to myocardial infarction in teenagers despite normal coronary angiography (Mir et al. (2011.

  14. Condition Assessment of Metal Oxide Surge Arrester Based on Multi-Layer SVM Classifier

    Directory of Open Access Journals (Sweden)

    M Khodsuz


    Full Text Available This paper introduces the indicators for surge arrester condition assessment based on the leakage current analysis. Maximum amplitude of fundamental harmonic of the resistive leakage current, maximum amplitude of third harmonic of the resistive leakage current and maximum amplitude of fundamental harmonic of the capacitive leakage current were used as indicators for surge arrester condition monitoring. Also, the effects of operating voltage fluctuation, third harmonic of voltage, overvoltage and surge arrester aging on these indicators were studied. Then, obtained data are applied to the multi-layer support vector machine for recognizing of surge arrester conditions. Obtained results show that introduced indicators have the high ability for evaluation of surge arrester conditions.

  15. Application of Powell's optimization method to surge arrester circuit models' parameters

    Energy Technology Data Exchange (ETDEWEB)

    Christodoulou, C.A.; Stathopulos, I.A. [National Technical University of Athens, School of Electrical and Computer Engineering, 9 Iroon Politechniou St., Zografou Campus, 157 80 Athens (Greece); Vita, V.; Ekonomou, L.; Chatzarakis, G.E. [A.S.PE.T.E. - School of Pedagogical and Technological Education, Department of Electrical Engineering Educators, N. Heraklion, 141 21 Athens (Greece)


    Powell's optimization method has been used for the evaluation of the surge arrester models parameters. The proper modelling of metal-oxide surge arresters and the right selection of equivalent circuit parameters are very significant issues, since quality and reliability of lightning performance studies can be improved with the more efficient representation of the arresters' dynamic behavior. The proposed approach selects optimum arrester model equivalent circuit parameter values, minimizing the error between the simulated peak residual voltage value and this given by the manufacturer. Application of the method in performed on a 120 kV metal oxide arrester. The use of the obtained optimum parameter values reduces significantly the relative error between the simulated and manufacturer's peak residual voltage value, presenting the effectiveness of the method. (author)

  16. Reversible cryo-arrest for imaging molecules in living cells at high spatial resolution (United States)

    Sabet, Ola; Wehner, Frank; Konitsiotis, Antonios; Fuhr, Günther R.; Bastiaens, Philippe I. H.


    The dynamics of molecules in living cells hamper precise imaging of molecular patterns by functional and super resolution microscopy. Circumventing lethal chemical fixation, an on-stage cryo-arrest was developed for consecutive imaging of molecular patterns within the same living, but arrested cells. The reversibility of consecutive cryo-arrests was demonstrated by the high survival rate of different cell lines and intact growth factor signaling that was not perturbed by stress response. Reversible cryo-arrest was applied to study the evolution of ligand-induced receptor tyrosine kinase activation at different scales. The nanoscale clustering of epidermal growth factor receptor (EGFR) in the plasma membrane was assessed by single molecule localization microscopy and endosomal microscale activity patterns of ephrin receptor type-A (EphA2) by fluorescence lifetime imaging microscopy. We thereby demonstrate that reversible cryo-arrest allows the precise determination of molecular patterns while conserving the dynamic capabilities of living cells. PMID:27400419

  17. [Characteristics and evolution of cardiopulmonary arrest in children in Spain: comparison between autonomous communities]. (United States)

    López-Herce Cid, J; García Sanz, C; Domínguez Sampedro, P; Carrillo Alvarez, A; Rodríguez Núñez, A; Calvo Macías, C


    In Spain there are many differences between autonomous regions in terms of geography, population distribution and health care organisation. We do not know if these differences could have influenced the characteristics and evolution of cardiopulmonary arrest in children. A secondary analysis of data from a prospective, multicenter and previously published study, analysing cardiorespiratory arrest in children was made to compare the characteristics and evolution of cardiopulmonary arrest in children depending on the region where the arrest occurred. We studied 283 children aged between 7 days and 17 years who suffered respiratory or cardiopulmonary arrest. Data were recorded according to the international Utstein style recommendations. Patients were classified according to the autonomous region where the cardiac arrest occurred: Catalonia (94 cases), Andalusia (64 cases), Madrid (61 cases) and the rest of the regions (64 patients). A statistical analysis was performed to compare the characteristics of cardiac arrest, resuscitation, evolution and survival between the four groups. Sixty percent of patients initially survived the cardiac arrest episode and 33% (94 patients) were still alive one year later. No significant differences in the characteristics of arrest, resuscitation and evolution were found when the autonomous regions were compared. Even though the differences were not statistically significant, there was a tendency to less than expected survival in Andalusia and higher than expected survival in Catalonia. There are no important differences in the characteristics of pediatric cardiopulmonary arrest, resuscitation, evolution and survival between the autonomous regions in Spain. Additional studies are needed to analyze the hypothetical influence of health care organization and life support training on survival.

  18. Cardiac arrest during gamete release in chum salmon regulated by the parasympathetic nerve system.

    Directory of Open Access Journals (Sweden)

    Yuya Makiguchi

    Full Text Available Cardiac arrest caused by startling stimuli, such as visual and vibration stimuli, has been reported in some animals and could be considered as an extraordinary case of bradycardia and defined as reversible missed heart beats. Variability of the heart rate is established as a balance between an autonomic system, namely cholinergic vagus inhibition, and excitatory adrenergic stimulation of neural and hormonal action in teleost. However, the cardiac arrest and its regulating nervous mechanism remain poorly understood. We show, by using electrocardiogram (ECG data loggers, that cardiac arrest occurs in chum salmon (Oncorhynchus keta at the moment of gamete release for 7.39+/-1.61 s in females and for 5.20+/-0.97 s in males. The increase in heart rate during spawning behavior relative to the background rate during the resting period suggests that cardiac arrest is a characteristic physiological phenomenon of the extraordinarily high heart rate during spawning behavior. The ECG morphological analysis showed a peaked and tall T-wave adjacent to the cardiac arrest, indicating an increase in potassium permeability in cardiac muscle cells, which would function to retard the cardiac action potential. Pharmacological studies showed that the cardiac arrest was abolished by injection of atropine, a muscarinic receptor antagonist, revealing that the cardiac arrest is a reflex response of the parasympathetic nerve system, although injection of sotalol, a beta-adrenergic antagonist, did not affect the cardiac arrest. We conclude that cardiac arrest during gamete release in spawning release in spawning chum salmon is a physiological reflex response controlled by the parasympathetic nervous system. This cardiac arrest represents a response to the gaping behavior that occurs at the moment of gamete release.

  19. Cardioprotection by sevoflurane against reperfusion injury after cardioplegic arrest in the rat is independent of three types of cardioplegia

    NARCIS (Netherlands)

    Ebel, D.; Preckel, B.; You, A.; Müllenheim, J.; Schlack, W.; Thämer, V.


    BACKGROUND: Sevoflurane protects the heart against reperfusion injury even after cardioplegic arrest. This protection may depend on the cardioplegic solution. Therefore, we investigated the effect of sevoflurane on myocardial reperfusion injury after cardioplegic arrest with University of Wisconsin

  20. Automated external defibrillators inaccessible to more than half of nearby cardiac arrests in public locations during evening, nighttime, and weekends

    DEFF Research Database (Denmark)

    Hansen, Carolina Malta; Wissenberg, Mads; Weeke, Peter


    BACKGROUND: Despite wide dissemination, use of automated external defibrillators (AEDs) in community settings is limited. We assessed how AED accessibility affected coverage of cardiac arrests in public locations. METHODS AND RESULTS: We identified cardiac arrests in public locations (1994...

  1. Crack arrestability of ship hull steel plate in accidental conditions: Application of high arrestability endowed ultra fine-grain surface layer steel

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Tadashi; Hagiwara, Yukito [Oita R and D Lab. (Japan); Oshita, Shigeru [Nippon Steel Corp., Oita (Japan). Oita Works; Inoue, Takehiro [Nippon Steel Corp., Futsu, Chiba (Japan). Steel Research Labs.; Hashimoto, Kunifumi; Kuroiwa, Takashi; Tada, Masuo [Mitsubishi Heavy Industries, Ltd., Nagasaki (Japan); Yajima, Hiroshi [Univ. of Hiroshima (Japan)


    A new type steel plate with ultra fine-grained surface layers (SUF steel) has been developed to improve crack arrestability. The application of this new type steel makes it possible to prevent catastrophic brittle fracture accidents of ship hull structures in emergency conditions, such as in serious collisions or groundings. It will reduce further the risk of casualties and environmental pollutions, caused by accidents of large crude oil carriers (VLCCs). The authors have investigated the validity for the application of the new type steel with ultra-high crack arrestability. Both computer simulations for collision of two VLCCs and large-scale fracture testings for crack arrestability have been carried out to study the accidental cases. The simulation results suggest that a collision generates a significant amount of plastic strain damage for the hull plate around a struck part. For example, the sheer strake plate near the struck part suffers 5 to 10% of plastic strain, before an inner-hull ruptures. Therefore, the effect of plastic strain (10% level) on crack arrestability of steel plates (the SUF plate and a conventional TMCP plate) was examined by standard ESSO tests, ultra wide-plate duplex ESSO tests, and sheer strake model tests. The test results are as follows: (1) Plastic strain deteriorates crack arrestability of steel plates. (2) Sufficient crack arrestability at 0 deg. C cannot be expected in the conventional TMCP steel plate plastically strained by about 10%. (3) The SUF plate maintains high crack arrestability even after introducing 10% plastic strain, at design temperature of 0 deg. C.

  2. Discrimination, arrest history, and major depressive disorder in the U.S. Black population. (United States)

    Anglin, Deidre M; Lighty, Quenesha; Yang, Lawrence H; Greenspoon, Michelle; Miles, Rashun J; Slonim, Tzachi; Isaac, Kathleen; Brown, Monique J


    Everyday discrimination contributes negatively to depressive symptomatology among Blacks in the US and being arrested could add to this depression. Using data from the National Survey on American Life, the present study determined the association between an arrest history and major depressive disorder (MDD), while accounting for discrimination among African Americans, US-born Afro-Caribbeans and first-generation Black immigrants. Findings from logistic regression analyses adjusted for discrimination suggested an arrest history is associated with 12-month MDD (Adjusted OR=1.47; 95% CI=1.02-2.10) and lifetime MDD (Adjusted OR=1.56 CI=1.17-2.09). Accounting for drug and alcohol dependence attenuated the association between arrest history and 12-month MDD, but not lifetime MDD. The associations between arrest history and both 12-month and lifetime MDD, and discrimination and lifetime MDD varied by ethnic/immigrant group. Specifically, while the association between arrest history and MDD (both 12-month and lifetime) was strongest among US-born Afro-Caribbeans, evidence consistent with the immigrant paradox, the association between discrimination and lifetime MDD was particularly relevant for first-generation Black immigrants, suggesting discrimination may hinder the protection of first-generation status. Mental health prevention and treatment programs should target the stress associated with being arrested and experiencing discrimination among US Blacks. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Communication between members of the cardiac arrest team--a postal survey. (United States)

    Pittman, J; Turner, B; Gabbott, D A


    Effective communication enhances team building and is perceived to improve the quality of team performance. A recent publication from the Resuscitation Council (UK) has highlighted this fact and recommended that cardiac arrest team members make contact daily. We wished to identify how often members of this team communicate prior to a cardiopulmonary arrest. A questionnaire on cardiac arrest team composition, leadership, communication and debriefing was distributed nationally to Resuscitation Training Officers (RTOs) and their responses analysed. One hundred and thirty (55%) RTOs replied. Physicians and anaesthetists were the most prominent members of the team. The Medical Senior House Officer is usually nominated as the team leader. Eighty-seven centres (67%) have no communication between team members prior to attending a cardiopulmonary arrest. In 33%, communication occurs but is either informal or fortuitous. The RTOs felt that communication is important to enhance team dynamics and optimise task allocation. Only 7% achieve a formal debrief following a cardiac arrest. Communication between members of the cardiac arrest team before and after a cardiac arrest is poor. Training and development of these skills may improve performance and should be prioritised. Team leadership does not necessarily reflect experience or training.

  4. Is extracorporeal rewarming indicated in avalanche victims with unwitnessed hypothermic cardiorespiratory arrest? (United States)

    Mair, Peter; Brugger, Hermann; Mair, Birgit; Moroder, Luca; Ruttmann, Elfriede


    International guidelines recommend using extracorporeal rewarming in all hypothermic avalanche victims with prolonged cardiac arrest if they have patent airways and a plasma potassium level≤12 mmol/L. The aim of this study was to evaluate outcome data to determine if available experience with extracorporeal rewarming of avalanche victims supports this recommendation. At Innsbruck Medical University Hospital, 28 patients with hypothermic cardiac arrest following an avalanche accident were resuscitated using extracorporeal circulation. Of these patients, 25 were extricated from the snow masses with no vital signs and did not survive to hospital discharge. Three patients had witnessed cardiac arrest after extrication and a core temperature of 21.7°C, 22°C, and 24.0°C, two of whom survived long-term with full neurological recovery. A search of the literature revealed only one asystolic avalanche victim with unwitnessed hypothermic cardiac arrest (core temperature 19°C) surviving long-term. All other avalanche victims in the medical literature surviving prolonged hypothermic cardiac arrest suffered witnessed arrest after extrication with a core temperature below 24°C. Our results suggest that prognosis of hypothermic avalanche victims with unwitnessed asystolic cardiac arrest and a core temperature>24°C is extremely poor. Available outcome data do not support the use of extracorporeal rewarming in these patients.

  5. Hypoxic ischemic brain injury following in hospital cardiac arrest - lessons from autopsy. (United States)

    Hinduja, Archana; Gupta, Harsh; Yang, Ju Dong; Onteddu, Sanjeeva


    Hypoxic ischemic brain injury (HIBI) is the most decisive factor in determining the outcome following a cardiac arrest. After an arrest, neuronal death may be early or delayed. The aim of our study is to determine the prevalence and predictors of HIBI on autopsy following an in hospital cardiac arrest. We retrospectively reviewed the medical records of patients who sustained an in hospital cardiorespiratory arrest and underwent autopsy following in hospital mortality at our tertiary care medical center from January 2004-June 2012. These patients were identified from the autopsy registry maintained by the Department of Pathology and were classified into two groups based on the presence or absence of HIBI on autopsy. We compared the baseline demographics, risk factors, total duration of cardiopulmonary resuscitation, number of resuscitative events and survival time between both groups. Multivariate logistic regression analysis was performed to identify predictors of hypoxic ischemic injury following cardiac arrest. Out of 71 patients identified during this study period, 21% had evidence of HIBI on autopsy. On univariate analysis, predictors of HIBI were prolonged hospital stay, prolonged survival time following an arrest and a slight increased trend following multiple resuscitative events. On multivariate analysis, prolonged survival time was the only significant predictor of HIBI. Similar to other prognostication cardiac arrest studies, there were minimal predictors of early neuronal injury even on autopsy. Published by Elsevier Ltd.

  6. Experimental study and local approach of cleavage crack arrest in a bainitic steel

    International Nuclear Information System (INIS)

    Dahl, A.


    EDF wants to complete the assessment of reactor pressure vessels, usually based on crack initiation concept, by crack arrest concept. The work aims at improving the knowledge of cleavage crack arrest in a reactor pressure vessel steel. For that purpose, isothermal crack arrest experiments were performed for temperatures ranging from - 150 C up to - 50 C on compact tensile specimens and on pre-cracked rings submitted to compressive loading. Fractographic observations revealed that the whole crack propagation and arrest occurs by cleavage even if ductile tearing occurs before initiation of the unstable crack propagation. A local cleavage crack arrest criterion is applied in finite element computations carried out in elasto-visco-plasticity and in full dynamics: the crack propagates since the largest principal stress reaches a critical stress. The application of this criterion on the experiments leads to a good prediction of the crack speed and of the crack length and shows that the critical stress increases with the temperature in relation with dissipation features observed on the fracture surfaces. Dependence to the geometry is observed; it can be due to the assumption used for the 2D computations. The study of the structural dynamic shows that the crack arrest phenomenon is very linked to the global dynamics of the structure: crack arrest and crack closure occur approximately at the same time. (author)

  7. Biallelic Mutations in PATL2 Cause Female Infertility Characterized by Oocyte Maturation Arrest. (United States)

    Chen, Biaobang; Zhang, Zhihua; Sun, Xiaoxi; Kuang, Yanping; Mao, Xiaoyan; Wang, Xueqian; Yan, Zheng; Li, Bin; Xu, Yao; Yu, Min; Fu, Jing; Mu, Jian; Zhou, Zhou; Li, Qiaoli; Jin, Li; He, Lin; Sang, Qing; Wang, Lei


    Oocyte maturation arrest results in female infertility, but the genetic determinants of human oocyte maturation arrest remain largely unknown. Previously, we identified TUBB8 mutations responsible for human oocyte maturation arrest, indicating the important role of genetic factors in the disorder. However, TUBB8 mutations account for only around 30% of individuals with oocyte maturation arrest; thus, the disorder is likely to involve other genetic factors that are as yet unknown. Here, we initially identified a homozygous nonsense mutation of PATL2 (c.784C>T [p.Arg262 ∗ ]) in a consanguineous family with a phenotype characterized by human oocyte germinal vesicle (GV) arrest. Subsequent mutation screening of PATL2 in a cohort of 179 individuals identified four additional independent individuals with compound-heterozygous PATL2 mutations with slight phenotypic variability. A genetic burden test further confirmed the genetic contribution of PATL2 to human oocyte maturation arrest. By western blot in HeLa cells, identification of splicing events in affected individuals' granulosa cells, and immunostaining in affected individuals' oocytes, we provide evidence that mutations in PATL2 lead to decreased amounts of protein. These findings suggest an important role for PATL2 mutations in oocyte maturation arrest and expand our understanding of the genetic basis of female infertility. Copyright © 2017 American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.

  8. Errors in the management of cardiac arrests: an observational study of patient safety incidents in England. (United States)

    Panesar, Sukhmeet S; Ignatowicz, Agnieszka M; Donaldson, Liam J


    The aim of this qualitative study is to better understand the types of error occurring during the management of cardiac arrests that led to a death. All patient safety incidents involving management of cardiac arrests and resulting in death which were reported to a national patient safety database over a 17-month period were analysed. Structured data from each report were extracted and these together with the free text, were subjected to content analysis which was inductive, with the coding scheme emerged from continuous reading and re-reading of incidents. There were 30 patient safety incidents involving management of cardiac arrests and resulting in death. The reviewers identified a main shortfall in the management of each cardiac arrest and this resulted in 12 different factors being documented. These were grouped into four themes that highlighted systemic weaknesses: miscommunication involving crash number (4/30, 13%), shortfalls in staff attending the arrest (4/30, 13%), equipment deficits (11/30, 36%), and poor application of knowledge and skills (11/30, 37%). The factors identified represent serious shortfalls in the quality of response to cardiac arrests resulting in death in hospital. No firm conclusion can be drawn about how many deaths in the study population would have been averted if the emergency had been managed to a high standard. The effective management of cardiac arrests should be considered as one of the markers of safe care within a healthcare organisation.

  9. Poisson cluster analysis of cardiac arrest incidence in Columbus, Ohio. (United States)

    Warden, Craig; Cudnik, Michael T; Sasson, Comilla; Schwartz, Greg; Semple, Hugh


    Scarce resources in disease prevention and emergency medical services (EMS) need to be focused on high-risk areas of out-of-hospital cardiac arrest (OHCA). Cluster analysis using geographic information systems (GISs) was used to find these high-risk areas and test potential predictive variables. This was a retrospective cohort analysis of EMS-treated adults with OHCAs occurring in Columbus, Ohio, from April 1, 2004, through March 31, 2009. The OHCAs were aggregated to census tracts and incidence rates were calculated based on their adult populations. Poisson cluster analysis determined significant clusters of high-risk census tracts. Both census tract-level and case-level characteristics were tested for association with high-risk areas by multivariate logistic regression. A total of 2,037 eligible OHCAs occurred within the city limits during the study period. The mean incidence rate was 0.85 OHCAs/1,000 population/year. There were five significant geographic clusters with 76 high-risk census tracts out of the total of 245 census tracts. In the case-level analysis, being in a high-risk cluster was associated with a slightly younger age (-3 years, adjusted odds ratio [OR] 0.99, 95% confidence interval [CI] 0.99-1.00), not being white, non-Hispanic (OR 0.54, 95% CI 0.45-0.64), cardiac arrest occurring at home (OR 1.53, 95% CI 1.23-1.71), and not receiving bystander cardiopulmonary resuscitation (CPR) (OR 0.77, 95% CI 0.62-0.96), but with higher survival to hospital discharge (OR 1.78, 95% CI 1.30-2.46). In the census tract-level analysis, high-risk census tracts were also associated with a slightly lower average age (-0.1 years, OR 1.14, 95% CI 1.06-1.22) and a lower proportion of white, non-Hispanic patients (-0.298, OR 0.04, 95% CI 0.01-0.19), but also a lower proportion of high-school graduates (-0.184, OR 0.00, 95% CI 0.00-0.00). This analysis identified high-risk census tracts and associated census tract-level and case-level characteristics that can be used to

  10. Infectious complications after out-of-hospital cardiac arrest-A comparison between two target temperatures

    DEFF Research Database (Denmark)

    Dankiewicz, Josef; Nielsen, Niklas; Linder, Adam


    BACKGROUND: It has been suggested that target temperature management (TTM) increases the probability of infectious complications after cardiac arrest. We aimed to compare the incidence of pneumonia, severe sepsis and septic shock after out-of-hospital cardiac arrest (OHCA) in patients with two...... complications were recorded daily during the ICU-stay. Pneumonia, severe sepsis and septic shock were considered infectious complications. Procalcitonin (PCT) and C-reactive-protein (CRP) levels were measured at 24h, 48h and 72h after cardiac arrest. RESULTS: There were 939 patients in the modified intention...

  11. Definition of testing procedures to check the performance of ZnO surge arresters in different environmental conditions

    International Nuclear Information System (INIS)

    Bargigia, A.; De Nigris, M.; Pigini, A.; Sironi, A.


    The performance of surge arresters under different environmental conditions involves three main aspects: the strength of the external insulation; heating of the internal active part of the surge arrester associated with voltage unbalance along the arrester that takes place with the external surface contaminated and wetted; ageing of the resistors blocks associated with chemical alterations that may occur inside the arrester under different environmental conditions lasting for a long time. This paper discusses the research work conducted in Italy to investigate all three aspects of the performance of ZnO surge arresters under different environmental conditions

  12. The perception of children of elementary education about cardiorespiratory arrest

    Directory of Open Access Journals (Sweden)

    Mariélli Terassi


    Full Text Available Cardiorespiratory arrest (CRA is a serious situation that occurs frequently in public environments, which makes assistance training of the general population of great importance. The objective was to understand the perception of children on CRA. Qualitative research conducted with children 8-10 years old enrolled in a private elementary school with a constructive proposal. Data collection occurred between the months of October and November 2013 in a recorded collective interview. As a criterion for inclusion students should be enrolled in the institution and accept to participate in the research with the consent of a guardian. Thirty children participated in the study. The students were divided into four groups: 5th year, 4th year, 3rd year A and 3rd year B, with an average of 08 students per group. The interviews were analyzed using the Bardin content analysis methodology. From the speeches, two categories emerged: Child's prior knowledge on CRA and how to act on the event of a CRA. Children associate the event of sudden CRA to a condition in which the heart and/or lungs suddenly stop acting. Seeking emergency assistance was reported as one of the main actions to be taken if a person is unconscious. It was observed that the 5th graders had best prior knowledge about the topic CRA when compared to students in the 3rd year. The thematic approach of CRA in schools contributes to the exchange of experiences, awareness of children and building new knowledge-oriented health education.

  13. Development of a virtual learning environment for cardiorespiratory arrest training

    Directory of Open Access Journals (Sweden)

    Anazilda Carvalho da Silva

    Full Text Available Abstract OBJECTIVE To develop a Virtual Learning Environment (VLE aiming at the training of nursing team workers and emergency vehicle drivers in Basic Life Support (BLS to attend Cardiorespiratory arrest, and to evaluate the quality of its contents among specialists in the area of Emergency and Urgent care. METHOD Applied research of technological development. The methodology used was based on the Instructional Design Model (ADDIE, which structures the teaching-learning planning in different stages (analysis, design, development, implementation and evaluation. The VLE was composed of texts elaborated from bibliographic research, links, edited video from a simulation scenario in the laboratory and questions to evaluate the fixation of the content, organized in modules. RESULTS After its development, it was evaluated as adequate to satisfy the needs of the target public, by eight expert judges, which was made available for electronic access. CONCLUSION The VLE has potential as a tool for training and qualification in BLS, as it can be easily integrated with other pedagogical approaches and strategies with active methodologies.


    Directory of Open Access Journals (Sweden)

    Catalin, MARINESCU


    Full Text Available The Treaty of Amsterdam stipulated the fact that the European Union must maintain and develop an area of freedom, security and justice, freedom assuming the existence of a common judicial area in which European citizens are able to seek justice in any of the member state same as in their own country. This goal aims to eliminate the possibility that criminals exploit the differences between the legal systems of the member states, imposing that the judgments are recognized and enforced abroad without the formalities laid down by the classical conventions on international judicial assistance. The Council Framework Decision 2002/584/JHA of 13 June 2002 on the European arrest warrant and the surrender procedures between Member States, materialized the decision taken in Tampere, following that between EU Member States to be replace the formal extradition procedure of the people who evade the execution of a sentence of imprisonment imposed by a judgment of conviction became final, with a simplified surrender procedure..

  15. Curcumin arrests endometriosis by downregulation of matrix metalloproteinase-9 activity. (United States)

    Swarnakar, Snehasikta; Paul, Sumit


    Curcumin, a polyphenol derived from turmeric (Curcuma longa) possesses diverse pharmacological properties including antioxidant, anti-inflammatory and antiproliferative activities. Endometriosis is a gyneocological disorder characterized by growth of endometrial tissues outside uterus that involves aberrant matrix remodeling. In this study the effect of curcumin was studied on surgically developed endometriosis in mice. Endometriosis with varying severity was developed in mice by peritoneal implantation of uterine fragments. The changes in matrix metalloproteinase (MMP)-9 and tissue inhibitor of metalloprotease (TIMP)-1 were investigated in endometriotic tissues following curcumin pre- and posttreatment. Results showed that MMP-9 activity increased gradually in endometriotic tissues with severity and curcumin treatment reversed the MMP-9 activity near to control value. Curcumin administered either post- or pre-endometriosis arrested endometriosis in a dose-dependent manner. It inhibited both MMP-9 activity and its expression at the level of secretion, during regression of endometriotic lesion. In addition, the attenuated activity of MMP-9 was associated with decreased expression of tumor necrosis factor-alpha (TNF-alpha) during healing, suggesting the anti-inflammatory property of curcumin. Moreover, curcumin pretreatment prevented lipid peroxidation and protein oxidation in endometriotic tissues. We reported here for the first time the anti-endometriotic property of curcumin via MMP-9 dependent pathway that may lead to new therapeutic intervention.

  16. Arrested recovery of Diadema antillarum population: Survival or recruitment limitation? (United States)

    Rodríguez-Barreras, Ruber; Pérez, María E.; Mercado-Molina, Alex E.; Sabat, Alberto M.


    Densities of the long-spined sea urchin Diadema antillarum remain significantly below pre mass-mortality levels at most Caribbean localities. The arrested recovery of this formerly abundant herbivore has been attributed to low supply of recruits and high post settlement mortality. There is, however, some debate as to which of these factors is determinant of the local dynamics of this echinoid. In this study, we use demographic modeling to analyze the contribution of recruitment and post settlement survival on the dynamics of D. antillarum in four localities of Puerto Rico Archipelago. Our results indicate relatively high adult survival, and low stasis but high growth transition in the small individuals. Recruitment rates were low and exhibited high spatial and temporal variability. The four populations exhibited asymptotic growth rates (λ) below 1.0, with λ varying from 0.918 to 0.964. The elasticity analysis showed that the survival of large-sized Diadema can potentially contribute most to the changes in λ for all sites. Numerical projections of the populations indicate that no site would exhibit an increase in density under current recruitment rates, but doubling recruitment would produce an increase in sea urchin density in three of the four sites. Recovery of D. antillarum populations would require the spatial and temporal co-occurrence of high recruitment and survival rates.

  17. Successful Management of Aluminium Phosphide Poisoning Resulting in Cardiac Arrest. (United States)

    Hakimoğlu, Sedat; Dikey, İsmail; Sarı, Ali; Kekeç, Leyla; Tuzcu, Kasım; Karcıoğlu, Murat


    Aluminum phosphide has high toxicity when it is ingested, and in case of contact with moisture, phosphine gas is released. Aluminum phosphide poisoning causes metabolic acidosis, arrhythmia, acute respiratory distress syndrome and shock, and there is no specific antidote. A 17-year-old male patient was referred to our hospital because of aluminum phosphide poisoning with 1500 mg of aluminum phosphide tablets. The patient's consciousness was clear but he was somnolent. Vital parameters were as follows: blood pressure: 85/56 mmHg, pulse: 88 beats/min, SpO2: 94%, temperature: 36.4°C. Because of hypotension, noradrenaline and dopamine infusions were started. The patient was intubated because of respiratory distress and loss of consciousness. Severe metabolic acidosis was determined in the arterial blood gas, and metabolic acidosis was corrected by sodium bicarbonate treatment. In addition to supportive therapy of the poisoning, haemodialysis was performed. Cardiac arrest occurred during follow-ups in the intensive care unit, and sinus rhythm was achieved after 10 min of cardiopulmonary resuscitation. The patient was discharged after three sessions of haemodialysis on the ninth day. As a result, haemodialysis contributed to symptomatic treatment of aluminum phosphide poisoning in this case report.

  18. The best timing for defibrillation in shockable cardiac arrest. (United States)

    Scapigliati, A; Ristagno, G; Cavaliere, F


    High quality cardiopulmonary resuscitation (CPR, i.e. chest compressions and ventilations) and prompt defibrillation when appropriate (i.e. in ventricular fibrillation and pulseless ventricular tachycardia, VF/VT) are currently the best early treatment for cardiac arrest (CA). In cases of prolonged CA due to shockable rhythms, it is reasonable to presume that a period of CPR before defibrillation could partially revert the metabolic and hemodynamic deteriorations imposed to the heart by the no flow state, thus increasing the chances of successful defibrillation. Despite supporting early evidences in CA cases in which Emergency Medical System response time was longer than 5 minutes, recent studies have failed to confirm a survival benefit of routine CPR before defibrillation. These data have imposed a change in guidelines from 2005 to 2010. To take in account all the variables encountered when treating CA (heart condition before CA, time elapsed, metabolic and hemodynamic changes, efficacy of CPR, responsiveness to defibrillation attempt), it would be very helpful to have a real-time and non invasive tool able to predict the chances of defibrillation success. Recent evidences have suggested that ECG waveform analysis of VF, such as the derived Amplitude Spectrum Area, can fit the purpose of monitoring the CPR effectiveness and predicting the responsiveness to defibrillation. While awaiting clinical studies confirming this promising approach, CPR performed according to high quality standard and with minimal interruptions together with early defibrillation are the best immediate way to achieve resuscitation in CA due to shochable rhythms..

  19. Increased risk of sudden cardiac arrest in obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Warnier, Miriam Jacoba; Blom, Marieke Tabo; Bardai, Abdennasser


    with electrocardiographic documentation of VT/VF were included. Conditional logistic regression analysis was used to assess the association between SCA and OPD. Pre-specified subgroup analyses were performed regarding age, sex, cardiovascular risk-profile, disease severity, and current use of respiratory drugs. RESULTS......BACKGROUND: We aimed to determine whether (1) patients with obstructive pulmonary disease (OPD) have an increased risk of sudden cardiac arrest (SCA) due to ventricular tachycardia or fibrillation (VT/VF), and (2) the SCA risk is mediated by cardiovascular risk-profile and/or respiratory drug use......: A higher risk of SCA was observed in patients with OPD (n = 190 cases [15%], 622 controls [11%]) than in those without OPD (OR adjusted for cardiovascular risk-profile 1.4 [1.2-1.6]). In OPD patients with a high cardiovascular risk-profile (OR 3.5 [2.7-4.4]) a higher risk of SCA was observed than in those...

  20. Adrenaline in cardiac arrest: Prefilled syringes are faster. (United States)

    Helm, Claire; Gillett, Mark


    Standard ampoules and prefilled syringes of adrenaline are widely available in Australasian EDs for use in cardiac arrest. We hypothesise that prefilled syringes can be administered more rapidly and accurately when compared with the two available standard ampoules. This is a triple arm superiority study comparing the time to i.v. administration and accuracy of dosing of three currently available preparations of adrenaline. In their standard packaging, prefilled syringes were on average more than 12 s faster to administer than the 1 mL 1:1000 ampoules and more than 16 s faster than the 10 mL 1:10,000 ampoules (P adrenaline utilising a Minijet (CSL Limited, Parkville, Victoria, Australia) is faster than using adrenaline in glass ampoules presented in their plastic packaging. Removing the plastic packaging from the 1 mL (1 mg) ampoule might result in more rapid administration similar to the Minijet. Resuscitation personnel requiring rapid access to adrenaline should consider storing it as either Minijets or ampoules devoid of packaging. These results might be extrapolatable to other clinical scenarios, including pre-hospital and anaesthesia, where other drugs are required for rapid use. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  1. Excessive chest compression rate is associated with insufficient compression depth in prehospital cardiac arrest

    NARCIS (Netherlands)

    Monsieurs, Koenraad G.; De Regge, Melissa; Vansteelandt, Kristof; De Smet, Jeroen; Annaert, Emmanuel; Lemoyne, Sabine; Kalmar, Alain F.; Calle, Paul A.


    Background and goal of study: The relationship between chest compression rate and compression depth is unknown. In order to characterise this relationship, we performed an observational study in prehospital cardiac arrest patients. We hypothesised that faster compressions are associated with

  2. History of Juvenile Arrests and Vocational Career Outcomes for At-Risk Young Men (United States)

    Wiesner, Margit; Kim, Hyoun K.; Capaldi, Deborah M.


    This study used longitudinal data from the Oregon Youth Study (OYS) to examine prospective effects of juvenile arrests, and of early versus late onset of juvenile offending, on two labor market outcomes by age 29/30 years. It was expected that those with more juvenile arrests and those with an early onset of offending would show poorer outcomes on both measures, controlling for propensity factors. Data were available for 203 men from the OYS, including officially recorded arrests and self-reported information on the men's work history across 9 years. Analyses revealed unexpected specificity in prospective effects: Juvenile arrests and mental health problems predicted the number of months unemployed; in contrast, being fired from work was predicted by poor child inhibitory control and adolescent substance use. Onset age of offending did not significantly predict either outcome. Implications of the findings for applied purposes and for developmental taxonomies of crime are discussed. PMID:20448840

  3. Too close for comfort? Registered sex offender spatial clustering and recidivistic sex crime arrest rates. (United States)

    Socia, Kelly M


    This study examined whether three measures of the spatial distribution of registered sex offenders (RSOs) in September 2010 were associated with differences in county-level rates of recidivistic sex crime arrests over the following year in 52 upstate New York counties. Results indicate that RSO clustering was positively associated with modest increases of recidivistic sex crime arrest rates, but results were significant only for adult victim sex crimes and only for certain types of RSO clustering. Under no circumstances, however, was increased RSO clustering associated with decreased rates of recidivistic sex crime arrests. The results of this study, combined with the limited prior research, suggest that RSO clustering has only a limited association with recidivistic sex crime arrest rates. This implies that housing policies such as residence restrictions may be useful in mitigating risk from some types of recidivistic sex crimes only to the extent that they result in more equitable distributions of RSOs within a county.

  4. Transfusion Associated Hyperkalemia and Cardiac Arrest in an Infant after Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    Do Wan Kim


    Full Text Available Cardiac arrest associated with hyperkalemia during red blood cell transfusion is a rare but fatal complication. Herein, we report a case of transfusion-associated cardiac arrest following the initiation of extracorporeal membrane oxygenation support in a 9-month old infant. Her serum potassium level was increased to 9.0 mEq/L, soon after the newly primed circuit with pre-stored red blood cell (RBC was started and followed by sudden cardiac arrest. Eventually, circulation was restored and the potassium level decreased to 5.1 mEq/L after 5 min. Extracorporeal membrane oxygenation (ECMO priming is a relatively massive transfusion into a pediatric patient. Thus, to prevent cardiac arrest during blood-primed ECMO in neonates and infants, freshly irradiated and washed RBCs should be used when priming the ECMO circuit, to minimize the potassium concentration. Also, physicians should be aware of all possible complications associated with transfusions during ECMO.

  5. Optimizing Neurologically Intact Survival from Sudden Cardiac Arrest: A Call to Action

    Directory of Open Access Journals (Sweden)

    Jeffrey M. Goodloe


    Full Text Available The U.S. national out-of-hospital and in-hospital cardiac arrest survival rates, although improving recently, have remained suboptimal despite the collective efforts of individuals, communities, and professional societies. Only until very recently, and still with inconsistency, has focus been placed specifically on survival with pre-arrest neurologic function. The reality of current approaches to sudden cardiac arrest is that they are often lacking an integrative, multi-disciplinary approach, and without deserved funding and outcome analysis. In this manuscript, a multidisciplinary group of authors propose practice, process, technology, and policy initiatives to improve cardiac arrest survival with a focus on neurologic function. [West J Emerg Med. 2014;15(7:-0.

  6. Medullary lesion revealed by MRI in a case of MS with respiratory arrest

    International Nuclear Information System (INIS)

    Mochizuki, A.; Yamanouchi, H.; Murata, M.; Nagura, H.; Kuzuhara, S.; Toyokura, Y.


    A 66-year-old MS patient who suffered respiratory arrest followed by complete remission is reported. Magnetic resonance imaging (MRI) revealed a medullary lesion. Clinicoradiological relationships are discussed. (orig.)

  7. Therapeutic Hypothermia and Out-of-Hospital Cardiac Arrest in a Child with Hypertrophic Obstructive Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Nancy Spurkeland


    Full Text Available Neurologic outcomes following pediatric cardiac arrest are consistently poor. Early initiation of cardiopulmonary resuscitation has been shown to have positive effects on both survival to hospital discharge, and improved neurological outcomes after cardiac arrest. Additionally, the use of therapeutic hypothermia may improve survival in pediatric cardiac arrest patients admitted to the intensive care unit. We report a child with congenital hypertrophic obstructive cardiomyopathy and an out-of-hospital cardiac arrest, in whom the early initiation of effective prolonged cardiopulmonary resuscitation and subsequent administration of therapeutic hypothermia contributed to a positive outcome with no gross neurologic sequelae. Continuing efforts should be made to promote and employ high-quality cardiopulmonary resuscitation, which likely contributed to the positive outcome of this case. Further research will be necessary to develop and solidify national guidelines for the implementation of therapeutic hypothermia in selected subpopulations of children with OHCA.

  8. Computed tomography may demonstrate pseudosubarachnoid hemorrhage in diffuse cerebral edema after cardiorespiratory arrest. (United States)

    Wong, Leonie C; Schelvan, Chris; Mitchell, L Ann; Inwald, David Philip


    To report the cases of two children who died from diffuse cerebral edema after cardiorespiratory arrest and who had radiologic findings of subarachnoid hemorrhage on computed tomography, the presence of which was excluded on subsequent postmortem examination. Case notes, clinical records, and postmortem reports of two children who became brain stem dead after cardiorespiratory arrest. Radiologic mimics of subarachnoid hemorrhage have been reported in the adult literature and are termed pseudosubarachnoid hemorrhage. A diagnosis of pseudosubarachnoid hemorrhage, rather than true subarachnoid hemorrhage, should be considered in the context of diffuse cerebral edema after cardiorespiratory arrest. Interpretation of the radiologic finding of subarachnoid hemorrhage in a child after a prolonged cardiac arrest should be cautious to avoid unnecessary and deleterious management and investigation for aneurysms.

  9. Recurrent respiratory distress and cardiopulmonary arrest caused by megaoesophagus secondary to achalasia

    Directory of Open Access Journals (Sweden)

    Nigel Tapiwa Mabvuure


    CONCLUSION: Oesophagectomy should be considered for patients with end-stage achalasia and mega-oesophagus causing respiratory compromise to avoid potential fatal complications such as tracheal compression and subsequent respiratory arrest.

  10. EU Citizenship and European Arrest Warrant: The Same Rights for All?

    Directory of Open Access Journals (Sweden)

    Tony Marguery


    Full Text Available In the case Wolzenburg, the principle of non-discrimination of European Union citizens is applied to the European arrest warrant. The implementation of the European arrest warrant by the Member States cannot escape a control of proportional- ity made by the Court. Member States may impose a period of residence of five years to foreign Europeans citizens in order for them to rely on an optional ground for non-execution of a European arrest warrant (Article 4(6 of the Framework Deci- sion on the European arrest warrant. Home nationals are not obliged to comply with a residence requirement. It is possible for Member States to justify an exception to the principle of non-discrimination of European citizens with a legitimate inter- est. The chances of social reintegration of a person convicted constitute such an interest. The national measure resulting in a difference of treatment must be proportional to that interest.

  11. Parameter identification of ZnO surge arrester models based on genetic algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Bayadi, Abdelhafid [Laboratoire d' Automatique de Setif, Departement d' Electrotechnique, Faculte des Sciences de l' Ingenieur, Universite Ferhat ABBAS de Setif, Route de Bejaia Setif 19000 (Algeria)


    The correct and adequate modelling of ZnO surge arresters characteristics is very important for insulation coordination studies and systems reliability. In this context many researchers addressed considerable efforts to the development of surge arresters models to reproduce the dynamic characteristics observed in their behaviour when subjected to fast front impulse currents. The difficulties with these models reside essentially in the calculation and the adjustment of their parameters. This paper proposes a new technique based on genetic algorithm to obtain the best possible series of parameter values of ZnO surge arresters models. The validity of the predicted parameters is then checked by comparing the predicted results with the experimental results available in the literature. Using the ATP-EMTP package, an application of the arrester model on network system studies is presented and discussed. (author)

  12. The 2006 National Labor Day impaired driving enforcement crackdown : Drunk driving. Over the limit. Under arrest. (United States)


    The National Highway Traffic Safety Administrations 2006 Drunk Driving. Over the Limit. Under Arrest. Labor Day holiday campaign had three main components: (1) DWI enforcement, (2) public awareness efforts, and (3) evaluation. The 2006 program use...

  13. Management of cardiac arrest caused by coronary artery spasm: epinephrine/adrenaline versus nitrates. (United States)

    Kiss, Gabor; Corre, Olivier; Gueret, Gildas; Nguyen Ba, Vinh; Gilard, Martine; Boschat, Jaques; Arvieux, Charles Chistian


    Cardiopulmonary resuscitation guidelines imply the use of epinephrine/adrenaline during cardiopulmonary arrest. However, in cardiac arrest situations resulting from coronary artery spasm (CAS), the use of epinephrine/adrenaline could be deleterious. A 49-year-old patient underwent an emergency coronarography with an attempt to stent the coronary arteries. Radiologic imaging revealed a positive methylergonovine maleate (Methergine, Novartis Pharmaceuticals, East Hanover, NJ) test, with subocclusive CAS in several coronary vessels leading to electromechanical dissociation. Cardiopulmonary resuscitation was performed, and intracoronary boluses of isosorbide dinitrate were given to treat CAS. Epinephrine/adrenaline was not administered during resuscitation. Spontaneous circulation was obtained after cardioversion for ventricular fibrillation, and the patient progressively regained consciousness. Resuscitation guidelines do not specify the use of trinitrate derivatives in cardiac arrest situations caused by CAS. The pros and cons of the use of nitrates and epinephrine/adrenaline during cardiac arrest caused by CAS are analyzed in this case report.

  14. [Anesthesia-related cardiac arrest in children. Data from a tertiary referral hospital registry]. (United States)

    Sanabria-Carretero, P; Ochoa-Osorio, C; Martín-Vega, A; Lahoz-Ramón, A; Rodríguez-Pérez, E; Reinoso-Barbero, F; Goldman-Tarlovsky, L


    The aim of this study is to analyze the cardiac arrests related to anesthesia in a tertiary children's hospital, in order to identify risk factors that would lead to opportunities for improvement. A 5-year retrospective study was conducted on anesthesia related cardiac arrest occurring in pediatric patients. All urgent and elective anesthetic procedures performed by anesthesiologists were included. Data collected included patient characteristics, the procedure, the probable cause, and outcome of the cardiac arrest. Odds ratio was calculated by univariate analysis to determine the clinical factors associated with cardiac arrest and mortality. There were a total of 15 cardiac arrests related to anesthesia in 43,391 anesthetic procedures (3.4 per 10,000), with an incidence in children with ASA I-II versus ASA≥III of 0.28 and 19.27 per 10,000, respectively. The main risk factors were children ASA≥III (P<.001), less than one month old (P<.001), less than one year old (P<.001), emergency procedures (P<.01), cardiac procedures (P<.001) and procedures performed in the catheterization laboratory (P<.05). The main causes of cardiac arrest were cardiovascular (53.3%), mainly due to hypovolemia, and cardiovascular depression associated with induction of anesthesia, followed by respiratory causes (20%), and medication causes (20%). The incidence of mortality and neurological injury within the first 24h after the cardiac arrest was 0.92 and 1.38 per 10,000, respectively. The mortality in the first 3 months was 1.6 per 10,000. The main causes of death were ASA≥III, age under one year, pulmonary arterial hypertension, cardiac arrest in areas remote from the surgery area, a duration of cardiopulmonary resuscitation over 20min, and when hypothermia was not applied after cardiac arrest. The main risk factors for cardiac arrest were ASA≥III, age under one year, emergency procedures, cardiology procedures and procedures performed in the catheterization laboratory. The main

  15. Postoperative cardiac arrest after heart surgery: does extracorporeal perfusion support a paradigm change in management? (United States)

    Gologorsky, Edward; Macedo, Francisco Igor B; Carvalho, Enisa M; Gologorsky, Angela; Ricci, Marco; Salerno, Tomas A


    Early institution of extracorporeal perfusion support (ECPS) may improve survival after cardiac arrest. Two patients sustained unexpected cardiac arrest in the Intensive Care Unit (ICU) following cardiac interventions. ECPS was initiated due to failure to restore hemodynamics after prolonged (over 60 minutes) advanced cardiac life support (ACLS) protocol-guided cardiopulmonary resuscitation. Despite relatively late institution of ECPS, both patients survived with preserved neurological function. This communication focuses on the utility of ECPS in the ICU as a part of resuscitative efforts.

  16. Automated external defibrillators and survival after in-hospital cardiac arrest. (United States)

    Chan, Paul S; Krumholz, Harlan M; Spertus, John A; Jones, Philip G; Cram, Peter; Berg, Robert A; Peberdy, Mary Ann; Nadkarni, Vinay; Mancini, Mary E; Nallamothu, Brahmajee K


    Automated external defibrillators (AEDs) improve survival from out-of-hospital cardiac arrests, but data on their effectiveness in hospitalized patients are limited. To evaluate the association between AED use and survival for in-hospital cardiac arrest. Cohort study of 11,695 hospitalized patients with cardiac arrests between January 1, 2000, and August 26, 2008, at 204 US hospitals following the introduction of AEDs on general hospital wards. Survival to hospital discharge by AED use, using multivariable hierarchical regression analyses to adjust for patient factors and hospital site. Of 11,695 patients, 9616 (82.2%) had nonshockable rhythms (asystole and pulseless electrical activity) and 2079 (17.8%) had shockable rhythms (ventricular fibrillation and pulseless ventricular tachycardia). AEDs were used in 4515 patients (38.6%). Overall, 2117 patients (18.1%) survived to hospital discharge. Within the entire study population, AED use was associated with a lower rate of survival after in-hospital cardiac arrest compared with no AED use (16.3% vs 19.3%; adjusted rate ratio [RR], 0.85; 95% confidence interval [CI], 0.78-0.92; P < .001). Among cardiac arrests due to nonshockable rhythms, AED use was associated with lower survival (10.4% vs 15.4%; adjusted RR, 0.74; 95% CI, 0.65-0.83; P < .001). In contrast, for cardiac arrests due to shockable rhythms, AED use was not associated with survival (38.4% vs 39.8%; adjusted RR, 1.00; 95% CI, 0.88-1.13; P = .99). These patterns were consistently observed in both monitored and nonmonitored hospital units where AEDs were used, after matching patients to the individual units in each hospital where the cardiac arrest occurred, and with a propensity score analysis. Among hospitalized patients with cardiac arrest, use of AEDs was not associated with improved survival.

  17. The Hidden Dangers of Beaches: Cardiorespiratory Arrest Induced by Thermal Shock


    Café, HM; Santos, S; Pereira, V; Chaves, S; Faria, P; Câmara, M; Nóbrega, J


    Thermal shock is widely recognized by modern medicine. Its pathophysiological mechanisms are known, as are its possible consequences, but scientific reports in the literature about clinical cases with severe consequences are sparse. The authors present a case of cardiorespiratory arrest after prolonged sun exposure followed by a dive in the ocean. Other aetiological causes were ruled out, by exclusion, leading to the diagnosis of cardiorespiratory arrest caused by thermal shock. It is importa...

  18. Radiological analyses of France Telecom surge arresters. Study performed for the CGT FAPT Cantal

    International Nuclear Information System (INIS)


    This document reports the radiological characterization of various versions of surge arresters used in the past to protect telephone lines against over-voltages. These equipment, which use various radioactive materials, were assessed by gamma radiation flow measurements, alpha-beta-gamma count rate measurements, dose rate measurements, gamma spectrometry analyses, tritium emanation test, radon 222 emanation test, smearing. Recommendations are formulated to manage radioactive surge arresters which are still being operated

  19. Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams

    DEFF Research Database (Denmark)

    Andersen, P.O.; Jensen, Michael Kammer; Lippert, A.


    2006 to November 2006. Interviews were focussed on barriers and recommendations for teamwork in the cardiac arrest team, optimal policy for improvement of resuscitation training and clinical practice, use of cognitive aids and adoption of European Resuscitation Council (ERC) Guidelines 2005. Interviews...... management. Important barriers that were identified were inexperienced team leaders, task overload and hierarchic structure in the teams' inability to maintain focus on chest compressions. Conclusion: Interview participants pointed out that NTSs of teams could improve the treatment of cardiac arrest...

  20. Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature


    Kumari, Anita; Gupta, Ruchi; Bajwa, Sukhminder Jit Singh; Singh, Amrinder


    Cardiac arrest during anesthesia and perioperative period is a matter of grave concern for any anesthesiologist. But such mishaps have been reported for one reason or the other in the literary sciences. We are reporting the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in two young and healthy patients. Fortunately, these patients were successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. Occurrence of such cases needs t...

  1. Parameters Calculation of ZnO Surge Arrester Models by Genetic Algorithms

    Directory of Open Access Journals (Sweden)

    A. Bayadi


    Full Text Available This paper proposes to provide a new technique based on the genetic algorithm to obtain the best possible series of values of the parameters of the ZnO surge arresters models. The validity of the predicted parameters is then checked by comparing the results predicted with the experimental results available in the literature. Using the ATP-EMTP package an application of the arrester model on network system studies is presented and discussed.

  2. A new on-line leakage current monitoring system of ZnO surge arresters

    International Nuclear Information System (INIS)

    Lee, Bok-Hee; Kang, Sung-Man


    This paper presents a new on-line leakage current monitoring system of zinc oxide (ZnO) surge arresters. To effectively diagnose the deterioration of ZnO surge arresters, a new algorithm and on-line leakage current detection device, which uses the time-delay addition method, for discriminating the resistive and capacitive currents was developed to use in the aging test and durability evaluation for ZnO arrester blocks. A computer-based measurement system of the resistive leakage current, the on-line monitoring device can detect accurately the leakage currents flowing through ZnO surge arresters for power frequency ac applied voltages. The proposed on-line leakage current monitoring device of ZnO surge arresters is more highly sensitive and gives more linear response than the existing devices using the detection method of the third harmonic leakage currents. Therefore, the proposed leakage current monitoring device can be useful for predicting the defects and performance deterioration of ZnO surge arresters in power system applications

  3. Protein synthetic requirements for caffeine amelioration of radiation-induced G/sub 2/-arrest

    International Nuclear Information System (INIS)

    Rowley, R.; Colkitt, D.


    Irradiated cells are arrested in G/sub 2/ (transition point [TP] = 32 min before cell selection in mitosis). Irradiated cells do not recover from G/sub 2/ arrest in the presence of cycloheximide (CHM) indicating dependence of recovery on protein synthesis. Irradiated cells in the presence of caffeine progress to mitosis without arrest. The authors investigate whether irradiated cells in the presence of caffeine require protein synthesis to progress to mitosis. Mitotic cell selection was used to monitor the progression of irradiated CHO cells (150 rad) during exposure to 5 mM caffeine and/or 50 μg/ml CHM. Protein synthesis inhibition was confirmed using /sup 3/H-leucine incorporation. Cells exposed to CHM alone are arrested in G/sub 2/ (TP=49 min), thus cells beyond this point have synthesized all proteins necessary for entry into mitosis. In the presence of caffeine, unirradiated cells exposed to CHM are not arrested at all in G/sub 2/, instead arrest occurs near the S/G/sub 2/ boundary (TP=95 min) indicating that caffeine alleviates the dependence of G/sub 2/ cell progression on protein synthesis. However, irradiated cells exposed to both caffeine and CHM are only able to progress to mitosis if beyond the CHM-TP. Irradiated cells in the presence of caffeine thus behave as untreated cells and require protein synthesis for progression to mitosis when prior to the CHM-TP

  4. Assessment of surge arrester failure rate and application studies in Hellenic high voltage transmission lines

    Energy Technology Data Exchange (ETDEWEB)

    Christodoulou, C.A.; Fotis, G.P.; Gonos, I.F.; Stathopulos, I.A. [National Technical University of Athens, School of Electrical and Computer Engineering, High Voltage Laboratory, 9 Iroon Politechniou St., Zografou Campus, 157 80 Athens (Greece); Ekonomou, L. [A.S.PE.T.E. - School of Pedagogical and Technological Education, Department of Electrical Engineering Educators, N. Heraklion, 141 21 Athens (Greece)


    The use of transmission line surge arresters to improve the lightning performance of transmission lines is becoming more common. Especially in areas with high soil resistivity and ground flash density, surge arresters constitute the most effective protection mean. In this paper a methodology for assessing the surge arrester failure rate based on the electrogeometrical model is presented. Critical currents that exceed arresters rated energy stress were estimated by the use of a simulation tool. The methodology is applied on operating Hellenic transmission lines of 150 kV. Several case studies are analyzed by installing surge arresters on different intervals, in relation to the region's tower footing resistance and the ground flash density. The obtained results are compared with real records of outage rate showing the effectiveness of the surge arresters in the reduction of the recorded failure rate. The presented methodology can be proved valuable to the studies of electric power systems designers intending in a more effective lightning protection, reducing the operational costs and providing continuity of service. (author)

  5. Recent developments in the management of patients resuscitated from cardiac arrest. (United States)

    Jentzer, Jacob C; Clements, Casey M; Murphy, Joseph G; Scott Wright, R


    Cardiac arrest is the leading cause of death in Europe and the United States. Many patients who are initially resuscitated die in the hospital, and hospital survivors often have substantial neurologic dysfunction. Most cardiac arrests are caused by coronary artery disease; patients with coronary artery disease likely benefit from early coronary angiography and intervention. After resuscitation, cardiac arrest patients remain critically ill and frequently suffer cardiogenic shock and multiorgan failure. Early cardiopulmonary stabilization is important to prevent worsening organ injury. To achieve best patient outcomes, comprehensive critical care management is needed, with primary goals of stabilizing hemodynamics and preventing progressive brain injury. Targeted temperature management is frequently recommended for comatose survivors of cardiac arrest to mitigate the neurologic injury that drives outcomes. Accurate neurologic assessment is central to managing care of cardiac arrest survivors and should combine physical examination with objective neurologic testing, with the caveat that delaying neurologic prognosis is essential to avoid premature withdrawal of supportive care. A combination of clinical findings and diagnostic results should be used to estimate the likelihood of functional recovery. This review focuses on recent advances in care and specific cardiac intensive care strategies that may improve morbidity and mortality for patients after cardiac arrest. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Arrested embryonic development: a review of strategies to delay hatching in egg-laying reptiles (United States)

    Rafferty, Anthony R.; Reina, Richard D.


    Arrested embryonic development involves the downregulation or cessation of active cell division and metabolic activity, and the capability of an animal to arrest embryonic development results in temporal plasticity of the duration of embryonic period. Arrested embryonic development is an important reproductive strategy for egg-laying animals that provide no parental care after oviposition. In this review, we discuss each type of embryonic developmental arrest used by oviparous reptiles. Environmental pressures that might have directed the evolution of arrest are addressed and we present previously undiscussed environmentally dependent physiological processes that may occur in the egg to bring about arrest. Areas for future research are proposed to clarify how ecology affects the phenotype of developing embryos. We hypothesize that oviparous reptilian mothers are capable of providing their embryos with a level of phenotypic adaptation to local environmental conditions by incorporating maternal factors into the internal environment of the egg that result in different levels of developmental sensitivity to environmental conditions after they are laid. PMID:22438503

  7. SMC1-mediated intra-S-phase arrest facilitates bocavirus DNA replication. (United States)

    Luo, Yong; Deng, Xuefeng; Cheng, Fang; Li, Yi; Qiu, Jianming


    Activation of a host DNA damage response (DDR) is essential for DNA replication of minute virus of canines (MVC), a member of the genus Bocavirus of the Parvoviridae family; however, the mechanism by which DDR contributes to viral DNA replication is unknown. In the current study, we demonstrate that MVC infection triggers the intra-S-phase arrest to slow down host cellular DNA replication and to recruit cellular DNA replication factors for viral DNA replication. The intra-S-phase arrest is regulated by ATM (ataxia telangiectasia-mutated kinase) signaling in a p53-independent manner. Moreover, we demonstrate that SMC1 (structural maintenance of chromosomes 1) is the key regulator of the intra-S-phase arrest induced during infection. Either knockdown of SMC1 or complementation with a dominant negative SMC1 mutant blocks both the intra-S-phase arrest and viral DNA replication. Finally, we show that the intra-S-phase arrest induced during MVC infection was caused neither by damaged host cellular DNA nor by viral proteins but by replicating viral genomes physically associated with the DNA damage sensor, the Mre11-Rad50-Nbs1 (MRN) complex. In conclusion, the feedback loop between MVC DNA replication and the intra-S-phase arrest is mediated by ATM-SMC1 signaling and plays a critical role in MVC DNA replication. Thus, our findings unravel the mechanism underlying DDR signaling-facilitated MVC DNA replication and demonstrate a novel strategy of DNA virus-host interaction.

  8. Histopathology of the pulp of primary molars with active and arrested dentinal caries. (United States)

    Di Nicolo, R; Guedes-Pinto, A C; Carvalho, Y R


    The purpose of this study was to compare the histological appearance of the pulp of human primary molars with active and arrested lesions. The sample consisted of 36 primary molars (18 with active lesions and 18 with arrested lesions) extracted from 35 children between 5 to 9 years of age. The histological diagnosis was classified in normal pulp, transitional stage, partial pulpitis, total pulpitis and total necrosis, and then subdivided in three subgroups: treatable, untreatable and questionable. Results showed that normal pulp or transitional stage (treatable category) was diagnosed in 50% of teeth with arrested lesions, compared to 11.1% of teeth with active lesions. Partial pulpitis (questionable category) was present in 38.8% with arrested lesions compared to 22.2% with active lesions. Total pulpitis and total necrosis (untreatable category) was diagnosed in 11.2% with arrested lesions compared to 66.7% with active lesions. The observed frequencies of histological categories between both groups were statistically significant (P calcio-traumatic line at the junction of the primary and reparative dentin, formation of reparative dentin and a regular odontoblastic layer in 60% of the cases. Results indicated that the type of lesion (active or arrested) is a good indicator of the histological status of the pulp.

  9. Transition of intestinal fatty acid-binding protein on hypothermic circulatory arrest with cardiopulmonary bypass. (United States)

    Kano, Hiroya; Takahashi, Hiroaki; Inoue, Takeshi; Tanaka, Hiroshi; Okita, Yutaka


    Intestinal fatty acid-binding protein (I-FABP) is increasingly employed as a highly specific marker of intestinal necrosis. However, the value of this marker associated with cardiovascular surgery with hypothermic circulatory arrest is unclear. The aim of this study was to measure serum I-FABP levels and provide the transition of I-FABP levels with hypothermic circulatory arrest to help in the management of intestinal perfusion. From August 2011 to September 2013, 33 consecutive patients who had aortic arch surgery with hypothermic circulatory arrest or heart valve surgery performed were enrolled in the study. Twenty patients had aortic surgery with hypothermic (23-29°C) circulatory arrest and 13 patients had heart valve surgery with cardiopulmonary bypass (33°C). I-FABP levels increased, both in patients undergoing aortic surgery with hypothermic circulatory arrest and heart valve surgery with cardiopulmonary bypass, reaching peak levels shortly after the administration of protamine. I-FABP levels in patients with aortic surgery were significantly higher with circulatory arrest. They reached peak levels immediately after recirculation and there was a significant drop at the end of surgery (parrest than in patients with heart valve surgery. However, no postoperative reperfusion injury occurred in the intestinal tract due to the use of hypothermic organ protection. Plasma I-FABP monitoring could be a valuable method for finding an intestinal ischemia in patients with cardiovascular surgery.

  10. Time to loss of brain function and activity during circulatory arrest. (United States)

    Pana, R; Hornby, L; Shemie, S D; Dhanani, S; Teitelbaum, J


    Brain function during the dying process and around the time of cardiac arrest is poorly understood. To better inform the clinical physiology of the dying process and organ donation practices, we performed a scoping review of the literature to assess time to loss of brain function and activity after circulatory arrest. Medline and Embase databases were searched from inception to June 2014 for articles reporting the time interval to loss of brain function or activity after loss of systemic circulation. Thirty-nine studies met selection criteria. Seven human studies and 10 animal studies reported that electroencephalography (EEG) activity is lost less than 30seconds after abrupt circulatory arrest. In the setting of existing brain injury, with progressive loss of oxygenated circulation, loss of EEG may occur before circulatory arrest. Cortical evoked potentials may persist for several minutes after loss of circulation. The time required to lose brain function varied according to clinical context and method by which this function is measured. Most studies show that clinical loss of consciousness and loss of EEG activity occur within 30seconds after abrupt circulatory arrest and may occur before circulatory arrest after progressive hypoxia-ischemia. Prospective clinical studies are required to confirm these observations. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Hypothermic circulatory arrest for acute traumatic aortic rupture associated with shock. (United States)

    Kawahito, Koji; Adachi, Hideo


    Hypothermic circulatory arrest is considered to be a contraindication in acute traumatic aortic rupture (TAR) because full heparinization and hypothermia may lead to fatal bleeding if concomitant hemorrhagic injuries are present. However, in extremely emergent situations, rapid volume infusion via cardiotomy vacuums and the institution of hypothermic circulatory arrest appears to be the only method for saving patients with uncontrollable bleeding. In this study, we evaluate the feasibility of hypothermic circulatory arrest for treating patients with TAR with hemorrhagic shock. Ten patients (nine men and one woman; mean age, 35 ± 18 years), with acute TAR caused by blunt chest trauma and in a shock state, underwent surgery between 1999 and 2007. All ten patients exhibited rupture of the isthmus, and polytraumatism was frequent. Any life-threatening blood loss from other injuries was surgically treated before aortic surgery. All patients were operated on with standard cardiopulmonary bypass under hypothermic circulatory arrest. All patients received prosthetic graft replacement. The overall hospital mortality was 10.0% (1/10). One patient died of intraabdominal and pulmonary bleeding during surgery, and the other nine were discharged without complications. There was no evidence of any new or increased hemorrhagic complications during heparinization in the nine surviving patients. Mean operation and circulatory arrest times were 305 ± 44 min and 27 ± 7 min, respectively. Hypothermic circulatory arrest is feasible for saving TAR patients with unstable hemodynamics resulting from rupture, provided associated injuries are properly treated in advance.

  12. Interdisciplinary ICU cardiac arrest debriefing improves survival outcomes*. (United States)

    Wolfe, Heather; Zebuhr, Carleen; Topjian, Alexis A; Nishisaki, Akira; Niles, Dana E; Meaney, Peter A; Boyle, Lori; Giordano, Rita T; Davis, Daniela; Priestley, Margaret; Apkon, Michael; Berg, Robert A; Nadkarni, Vinay M; Sutton, Robert M


    In-hospital cardiac arrest is an important public health problem. High-quality resuscitation improves survival but is difficult to achieve. Our objective is to evaluate the effectiveness of a novel, interdisciplinary, postevent quantitative debriefing program to improve survival outcomes after in-hospital pediatric chest compression events. Single-center prospective interventional study of children who received chest compressions between December 2008 and June 2012 in the ICU. Structured, quantitative, audiovisual, interdisciplinary debriefing of chest compression events with front-line providers. Primary outcome was survival to hospital discharge. Secondary outcomes included survival of event (return of spontaneous circulation for ≥ 20 min) and favorable neurologic outcome. Primary resuscitation quality outcome was a composite variable, termed "excellent cardiopulmonary resuscitation," prospectively defined as a chest compression depth ≥ 38 mm, rate ≥ 100/min, ≤ 10% of chest compressions with leaning, and a chest compression fraction > 90% during a given 30-second epoch. Quantitative data were available only for patients who are 8 years old or older. There were 119 chest compression events (60 control and 59 interventional). The intervention was associated with a trend toward improved survival to hospital discharge on both univariate analysis (52% vs 33%, p = 0.054) and after controlling for confounders (adjusted odds ratio, 2.5; 95% CI, 0.91-6.8; p = 0.075), and it significantly increased survival with favorable neurologic outcome on both univariate (50% vs 29%, p = 0.036) and multivariable analyses (adjusted odds ratio, 2.75; 95% CI, 1.01-7.5; p = 0.047). Cardiopulmonary resuscitation epochs for patients who are 8 years old or older during the debriefing period were 5.6 times more likely to meet targets of excellent cardiopulmonary resuscitation (95% CI, 2.9-10.6; p < 0.01). Implementation of an interdisciplinary, postevent quantitative debriefing

  13. Sudden Cardiac Arrest During Sports Activity in Middle Age (United States)

    Marijon, Eloi; Uy-Evanado, Audrey; Reinier, Kyndaron; Teodorescu, Carmen; Narayanan, Kumar; Jouven, Xavier; Gunson, Karen; Jui, Jonathan; Chugh, Sumeet S.


    Background Sports-associated sudden cardiac arrests (SCAs) occur mostly during middle age. We sought to determine burden, characteristics, and outcomes of SCA during sports among middle aged residents of a large US community. Methods and Results SCA cases aged 35–65 years were identified in a large, prospective, population-based study (2002–2013), with systematic and comprehensive assessment of their lifetime medical history. Of the 1,247 SCA cases, 63 (5%) occurred during sports activities at a mean age of 51.1±8.8 years, yielding an incidence of 21.7 (95%CI 8.1–35.4) per million per year. The incidence varied significantly based on sex, with a higher incidence among men (RR 18.68 95%CI 2.50–139.56) for sports SCA, as compared to all other SCA (RR 2.58, 95%CI 2.12–3.13). Sports SCA was also more likely to be a witnessed event (87 vs. 53%, Psports-associated SCA (23.2 vs. 13.6%, P=0.04). Sports SCA cases presented with known pre-existing cardiac disease in 16%, ≥1 cardiovascular risk factor in 56%, and overall, 36% of cases had typical cardiovascular symptoms during the week preceding SCA. Conclusions Sports-associated SCA in middle age represents a relatively small proportion of the overall SCA burden, reinforcing the idea of the high benefit-low risk nature of sports activity. Especially in light of current population aging trends, our findings emphasize that targeted education could maximize both safety and acceptance of sports activity in the older athlete. PMID:25847988

  14. Mechanisms involved in alternariol-induced cell cycle arrest

    Energy Technology Data Exchange (ETDEWEB)

    Solhaug, A., E-mail: [Norwegian Veterinary Institute, Oslo (Norway); Vines, L.L. [Michigan State University, Department of Food Science and Human Nutrition, East Lansing, MI (United States); Ivanova, L.; Spilsberg, B. [Norwegian Veterinary Institute, Oslo (Norway); Holme, J.A. [Norwegian Institute of Public Health, Division of Environmental Medicine, Oslo (Norway); Pestka, J. [Michigan State University, Department of Food Science and Human Nutrition, East Lansing, MI (United States); Collins, A. [University of Oslo, Department of Nutrition, Faculty of Medicine, Oslo (Norway); Eriksen, G.S. [Norwegian Veterinary Institute, Oslo (Norway)


    Alternariol (AOH), a mycotoxin produced by Alternaria sp, is often found as a contaminant in fruit and cereal products. Here we employed the murine macrophage cell line RAW 264.7 to test the hypothesis that AOH causes toxicity as a response to DNA damage. AOH at concentrations of 15-30 {mu}M almost completely blocked cell proliferation. Within 30 min treatment, AOH (30 {mu}M) significantly increased the level of reactive oxygen species (ROS). Furthermore, DNA base oxidations as well as DNA strand breaks and/or alkaline labile sites were detected by the comet assay after 2 h exposure of AOH. Cell death (mostly necrosis) was observed after prolonged exposure to the highest concentration of AOH (60 {mu}M for 24 and 48 h) in our study. The DNA damage response involved phosphorylation (activation) of histone H2AX and check point kinase-1- and 2 (Chk-1/2). Moreover, AOH activated p53 and increased the expression of p21, Cyclin B, MDM2, and Sestrin 2; likewise the level of several miRNA was affected. AOH-induced Sestrin 2 expression was regulated by p53 and could at least partly be inhibited by antioxidants, suggesting a role of ROS in the response. Interestingly, the addition of antioxidants did not inhibit cell cycle arrest. Although the formation of ROS by itself was not directly linked cell proliferation, AOH-induced DNA damage and resulting transcriptional changes in p21, MDM2, and Cyclin B likely contribute to the reduced cell proliferation; while Sestrin 2 would contribute to the oxidant defense.

  15. Cardiac arrest in the toilet: clinical characteristics and resuscitation profiles. (United States)

    Inamasu, Joji; Miyatake, Satoru


    The great majority of non-traumatic cardiac arrests (CA) occur at home. The toilet is a closed and private room where CA occurs frequently. However, due to the feelings of privacy that are associated with this room, the circumstances and causes of CA in the toilet have rarely been investigated. A retrospective study was conducted to clarify clinical characteristics and resuscitation profiles of patients sustaining CA in the toilet. Among 907 CA patients treated during a 4-year period, 101 (11 %) sustained CA in the toilet. While the collapse was witnessed in only 10 % of these patients, return of spontaneous circulation (ROSC) was achieved in 41 %. However, the long-term survival rate was 1 %. Multivariate regression analysis revealed that a history of cardiac diseases was predictive of CA in the toilet (odds ratio 3.045; 95 % confidence interval 1.756-5.282) but that there was no correlation with advanced age. The frequency of CA in the toilet may be influenced moderately by seasonal/circadian variations. The 101 patients were classified into four subgroups according to mode of discovery of CA. The frequency of ROSC was highest in those who collapsed in the presence of caregivers and lowest in those whose collapse were discovered later by family members being worried that the patient stayed in the toilet "too long." Imaging studies revealed life-threatening extra-cardiac lesions responsible for CA, such as subarachnoid hemorrhage and aortic dissection, in 23 % of the patient cohort. The rarity of long-term survival among individuals sustaining CA in the toilet is mainly due to the delay in discovering the individual who collapsed. Although a history of cardiac diseases is a risk factor, predicting who may sustain CA in the toilet remains difficult due to etiological heterogeneity.

  16. The Arrested Black Men in Europe: Criminal or Victim?

    Directory of Open Access Journals (Sweden)

    Michael Platzer


    Full Text Available The Africans detained in Austria have been targeted by police by their skin color, often are arrested with violence, are poorly defended by assigned defense lawyers, given longer sentences than Austrian citizens and have less access to alternatives or bail.A modified form of the United Nations Crime Victim questionnaire was administered to all the African prisoners at the Vienna’s Central Detention Facility. It revealed that the Africans were not only victims of violence (sometimes even torture and crimes (assault-58%, burglary-32%, fraud-27%, bribery-33% in their home countries, but also 24 percent had experienced assault, 16% theft, and 13% had been defrauded in Austria-much higher rates than the EU citizen. On the other hand, the Africans are rarely charged with burglary, robbery, or violent crimes. They are primarily arrested for the possession or sale of narcotic drugs (83% and an additional four percent for resisting arrest. This is primarily the result of insufficient financial support provided to asylum seekers and the prohibition to work pending their determination of immigrant status. Because of the long appeal processes and the practical impossibility of deporting certain nationalities, a type of underground community is taking root where simple survival is the determining factor whether to commit a non-violent offence. Les Africains détenus en Autriche sont visés par la police à cause de la couleur de leur peau; ils sont souvent arrêtés avec violence, sont mal défendus par leurs avocats de défense, doivent passer de plus longues périodes en prison que des citoyens autrichiens ayant commis un crime pareil, et ils ont moins d'accès aux mesures extrajudiciaires et au système de liberté sous caution. Une forme modifiée du questionnaire de victimes de crime des Nations Unies fut administrée à tous les prisonniers africains au Service Central de la Détention de Vienne. Les résultats indiquèrent que les Africains furent

  17. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Wissenberg, Mads; Lippert, Freddy K.; Folke, Fredrik


    temporal changes in bystander resuscitation attempts and survival during a 10-year period in which several national initiatives were taken to increase rates of bystander resuscitation and improve advanced care. DESIGN, SETTING, AND PARTICIPANTS Patients with out-of-hospital cardiac arrest for which...

  18. Establishing a Rodent Model of Ventricular Fibrillation Cardiac Arrest with Graded Histologic and Neurologic Damage with Different Cardiac Arrest Durations. (United States)

    Ettl, Florian; Magnet, Ingrid A M; Weihs, Wolfgang; Warenits, Alexandra; Grassmann, Daniel; Wagner, Michael; Teubenbacher, Ursula; Högler, Sandra; Sterz, Fritz; Janata, Andreas


    To establish a ventricular fibrillation (VF) cardiac arrest (CA) resuscitation model with consistent neurologic and neuropathologic damage as potential therapeutic target. Prospectively randomized groups of experiments in 2 phases. In phase 1 four groups of male Sprague-Dawley rats (n = 5) were resuscitated after 6 min VFCA with 2 and 6 min basic life support durations (BLS) with and without adrenaline. In phase 2 the most promising group regarding return of spontaneous circulation (ROSC) and survival was compared to a group of 8 min CA. Resuscitability, neurologic deficit scores (NDS) and overall performance category (OPC) were assessed daily; histolopathology of the hippocampal CA1 region [hematoxylin and eosin- (viable neurons), Fluoro-Jade- (dying neurons) and Iba-1 Immuno-staining (microglial activation - semiquantitative)] on day 14. Two minutes BLS and with adrenaline as most promising group of phase 1 compared to an 8 min group in phase 2 exhibited ROSC in 8 (80%) vs. 9 (82%) animals and survivors till day 14 in 7 (88%) (all OPC 1, NDS 0 ± 0) vs. 6 (67%) (5 OPC 1, 1 OPC 2, NDS 0.83 ± 2.4) animals. OPC and NDS were only significantly different at day 1 (OPC: p = 0.035 NDS: p = 0.003). Histopathologic results between groups were not significantly different, however a smaller variance of extent of lesions was found in the 8 min group. Both CA durations caused graded neurologic, overall, such as histopathologic damage. This dynamic global ischemia model offers the possibility to evaluate further cognitive and novel neuroprotective therapy testing after CA.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  19. The Effects of Local Police Surges on Crime and Arrests in New York City. (United States)

    MacDonald, John; Fagan, Jeffrey; Geller, Amanda


    The New York Police Department (NYPD) under Operation Impact deployed extra police officers to high crime areas designated as impact zones. Officers were encouraged to conduct investigative stops in these areas. City officials credited the program as one of the leading causes of New York City's low crime rate. We tested the effects of Operation Impact on reported crimes and arrests from 2004 to 2012 using a difference-in-differences approach. We used Poisson regression models to compare differences in crime and arrest counts before and after census block groups were designated as impact zones compared to census block groups in the same NYPD precincts but outside impact zones. Impact zones were significantly associated with reductions in total reported crimes, assaults, burglaries, drug violations, misdemeanor crimes, felony property crimes, robberies, and felony violent crimes. Impact zones were significantly associated with increases in total reported arrests, arrests for burglary, arrests for weapons, arrests for misdemeanor crimes, and arrests for property felony crimes. Impact zones were also significantly associated with increases in investigative stops for suspected crimes, but only the increase in stops made based on probable cause indicators of criminal behaviors were associated with crime reductions. The largest increase in investigative stops in impact zones was based on indicators of suspicious behavior that had no measurable effect on crime. The findings suggest that saturating high crime blocks with police helped reduce crime in New York City, but that the bulk of the investigative stops did not play an important role in the crime reductions. The findings indicate that crime reduction can be achieved with more focused investigative stops.

  20. The Effects of Local Police Surges on Crime and Arrests in New York City.

    Directory of Open Access Journals (Sweden)

    John MacDonald

    Full Text Available The New York Police Department (NYPD under Operation Impact deployed extra police officers to high crime areas designated as impact zones. Officers were encouraged to conduct investigative stops in these areas. City officials credited the program as one of the leading causes of New York City's low crime rate. We tested the effects of Operation Impact on reported crimes and arrests from 2004 to 2012 using a difference-in-differences approach. We used Poisson regression models to compare differences in crime and arrest counts before and after census block groups were designated as impact zones compared to census block groups in the same NYPD precincts but outside impact zones. Impact zones were significantly associated with reductions in total reported crimes, assaults, burglaries, drug violations, misdemeanor crimes, felony property crimes, robberies, and felony violent crimes. Impact zones were significantly associated with increases in total reported arrests, arrests for burglary, arrests for weapons, arrests for misdemeanor crimes, and arrests for property felony crimes. Impact zones were also significantly associated with increases in investigative stops for suspected crimes, but only the increase in stops made based on probable cause indicators of criminal behaviors were associated with crime reductions. The largest increase in investigative stops in impact zones was based on indicators of suspicious behavior that had no measurable effect on crime. The findings suggest that saturating high crime blocks with police helped reduce crime in New York City, but that the bulk of the investigative stops did not play an important role in the crime reductions. The findings indicate that crime reduction can be achieved with more focused investigative stops.

  1. Public-Access Defibrillation and Out-of-Hospital Cardiac Arrest in Japan. (United States)

    Kitamura, Tetsuhisa; Kiyohara, Kosuke; Sakai, Tomohiko; Matsuyama, Tasuku; Hatakeyama, Toshihiro; Shimamoto, Tomonari; Izawa, Junichi; Fujii, Tomoko; Nishiyama, Chika; Kawamura, Takashi; Iwami, Taku


    Early defibrillation plays a key role in improving survival in patients with out-of-hospital cardiac arrests due to ventricular fibrillation (ventricular-fibrillation cardiac arrests), and the use of publicly accessible automated external defibrillators (AEDs) can help to reduce the time to defibrillation for such patients. However, the effect of dissemination of public-access AEDs for ventricular-fibrillation cardiac arrest at the population level has not been extensively investigated. From a nationwide, prospective, population-based registry of patients with out-of-hospital cardiac arrest in Japan, we identified patients from 2005 through 2013 with bystander-witnessed ventricular-fibrillation arrests of presumed cardiac origin in whom resuscitation was attempted. The primary outcome measure was survival at 1 month with a favorable neurologic outcome (Cerebral Performance Category of 1 or 2, on a scale from 1 [good cerebral performance] to 5 [death or brain death]). The number of patients in whom survival with a favorable neurologic outcome was attributable to public-access defibrillation was estimated. Of 43,762 patients with bystander-witnessed ventricular-fibrillation arrests of cardiac origin, 4499 (10.3%) received public-access defibrillation. The percentage of patients receiving public-access defibrillation increased from 1.1% in 2005 to 16.5% in 2013 (PThe percentage of patients who were alive at 1 month with a favorable neurologic outcome was significantly higher with public-access defibrillation than without public-access defibrillation (38.5% vs. 18.2%; adjusted odds ratio after propensity-score matching, 1.99; 95% confidence interval, 1.80 to 2.19). The estimated number of survivors in whom survival with a favorable neurologic outcome was attributed to public-access defibrillation increased from 6 in 2005 to 201 in 2013 (Pbystanders was associated with an increase in the number of survivors with a favorable neurologic outcome after out

  2. Assessing Trends in Women’s Violence via Data Triangulation: Arrests, Convictions, Incarcerations, & Victim Reports (United States)

    Schwartz, Jennifer; Steffensmeier, Darrell J.; Feldmeyer, Ben


    Constructionist theories suggest the national rise in female violence arrests may be policy-generated because arrest statistics are produced by violent behavior and changing official responses (e.g., net-widening enforcement policies). Normative theories attribute the rise to female behavior changes (e.g., in response to increased freedoms or hardships). We examine whether any narrowing of the arrest gender gap is borne out across offense types of varying measurement reliability, in victimization data, and across two post-arrest criminal justice stages. Advanced time-series analyses over 1980–2003 support the constructionist position – first, all sources show little or no increase in women’s rates for the more reliably measured offenses of homicide and robbery, and for rape; second, the assault gender gap narrows for arrests, but holds stable in victimization data; third, the assault gender gap narrows moderately for convictions, but is stable for imprisonment, indicating spill-over effects of more expansive arrest policies. Several factors have produced greater female representation in “criminal assault” arrests including (i) proactive policing targeting and formally responding to minor violence and in private contexts, (ii) interventionist developmental epistemologies that blur distinctions among violence types and circumstances, (iii) the rise of social movements recognizing “hidden” victims, (iv) law and order political messages stressing greater accountability, and (v) the somewhat greater decline in male compared to female violence in the late 1990s. The problem of women’s violence is largely a social construction. Rather than women becoming more violent, changes in the management of violence increasingly mask differences in the violence levels of women and men. PMID:25589794

  3. Cell cycle arrest and cell survival induce reverse trends of cardiolipin remodeling.

    Directory of Open Access Journals (Sweden)

    Yu-Jen Chao

    Full Text Available Cell survival from the arrested state can be a cause of the cancer recurrence. Transition from the arrest state to the growth state is highly regulated by mitochondrial activity, which is related to the lipid compositions of the mitochondrial membrane. Cardiolipin is a critical phospholipid for the mitochondrial integrity and functions. We examined the changes of cardiolipin species by LC-MS in the transition between cell cycle arrest and cell reviving in HT1080 fibrosarcoma cells. We have identified 41 cardiolipin species by MS/MS and semi-quantitated them to analyze the detailed changes of cardiolipin species. The mass spectra of cardiolipin with the same carbon number form an envelope, and the C64, C66, C68, C70 C72 and C74 envelopes in HT1080 cells show a normal distribution in the full scan mass spectrum. The cardiolipin quantity in a cell decreases while entering the cell cycle arrest, but maintains at a similar level through cell survival. While cells awakening from the arrested state and preparing itself for replication, the groups with short acyl chains, such as C64, C66 and C68 show a decrease of cardiolipin percentage, but the groups with long acyl chains, such as C70 and C72 display an increase of cardiolipin percentage. Interestingly, the trends of the cardiolipin species changes during the arresting state are completely opposite to cell growing state. Our results indicate that the cardiolipin species shift from the short chain to long chain cardiolipin during the transition from cell cycle arrest to cell progression.

  4. Pseudolaric acid B induced cell cycle arrest, autophagy and senescence in murine fibrosarcoma l929 cell. (United States)

    Yu, Jing hua; Liu, Chun yu; Zheng, Gui bin; Zhang, Li Ying; Yan, Ming hui; Zhang, Wen yan; Meng, Xian ying; Yu, Xiao fang


    PAB induced various cancer cell apoptosis, cell cycle arrest and senescence. But in cell line murine fibrosarcoma L929, PAB did not induce apoptosis, but autophagy, therefore it was thought by us as a good model to research the relationship of cell cycle arrest, autophagy and senescence bypass apoptosis. Inhibitory ratio was assessed by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) analysis. Phase contrast microscopy visualized cell morphology. Hoechst 33258 staining for nuclear change, propidium iodode (PI) staining for cell cycle, monodansylcadaverine (MDC) staining for autophagy, and rodanmine 123 staining for mitochondrial membrane potential (MMP) were measured by fluorescence microscopy or flowcytometry. Apoptosis was determined by DNA ladder test. Protein kinase C (PKC) activity was detected by PKC assay kit. SA-β-galactosidase assay was used to detect senescence. Protein expression was examined by western blot. PAB inhibited L929 cell growth in time-and dose-dependent manner. At 12 h, 80 μmol/L PAB induced obvious mitotic arrest; at 24 h, PAB began to induce autophagy; at 36 h, cell-treated with PAB slip into G1 cell cycle; and 3 d PAB induced senescence. In time sequence PAB induced firstly cell cycle arrest, then autophagy, then slippage into G1 phase, lastly senescence. Senescent cells had high level of autophagy, inhibiting autophagy led to apoptosis, and no senescence. PAB activated PKC activity to induce cell cycle arrest, autophagy and senescence, inhibiting PKC activity suppressed cell cycle arrest, autophagy and senescence. PAB induced cell cycle arrest, autophagy and senescence in murine fibrosarcoma L929 cell through PKC.

  5. Outcome in 757 severely injured patients with traumatic cardiorespiratory arrest. (United States)

    Huber-Wagner, Stefan; Lefering, Rolf; Qvick, Mike; Kay, Michael V; Paffrath, Thomas; Mutschler, Wolf; Kanz, Karl-Georg


    Resuscitation of traumatic cardiorespiratory arrest patients (TCRA) is generally associated with poor outcome, however some authors report survival rates of more than 10% in blunt trauma patients. The purpose of this investigation was to determine predictive factors for mortality in trauma patients having received external chest compressions (ECC). Twenty thousand eight hundred and fifteen patients from the Trauma Registry of the German Trauma Society were analysed (mean ISS=24.0). Inclusion criteria were ISS>/=16 and available information on ECC either on-scene and/or during trauma room treatment. Included into the Trauma Registry were only patients with ECC and transportation into a hospital. Patients declared dead on-scene without transportation to a hospital were not recorded in the data base. A Logistic regression was performed to find out predictive factors for mortality. Ten thousand three hundred and fifty nine patients fulfilled the inclusion criteria. N=757 patients received ECC, 415 prehospital, 538 during trauma room (TR) treatment and 196 prehospital and in-hospital. Blunt trauma occurred in 93.2%, mean age was 40.3 and median ISS was 41.0. 23.2% of the patients were treated with a chest tube, 5.7% had a tension pneumothorax and 10.2% underwent emergency thoracotomy. The overall survival rate was 17.2%. 9.7% of the TCRA patients with ECC achieved good recovery or moderate disability (Glasgow outcome scale>/=4). Logistic regression showed thromboplastin time lower than 50% to be the strongest predictor for non-survival (OR 5.2, 95% CI 2.3-11.9), followed by massive blood transfusion of more than 10 units of packed red blood cells (OR 4.8, 95% CI 2.0-11.5), on-scene blood pressure of 0 (OR 4.3, 95% CI 1.6-11.3), age over 55 (OR 2.9, 95% CI 1.1-7.3), base excess lower than -8 (OR 2.7, 95% CI 1.2-5.9). The insertion of a chest tube on-scene could be detected as a factor significantly increasing the probability of survival (OR 0.3, 95% CI 0

  6. Development of a virtual learning environment for cardiorespiratory arrest training. (United States)

    Silva, Anazilda Carvalho da; Bernardes, Andrea; Évora, Yolanda Dora Martinez; Dalri, Maria Célia Barcellos; Silva, Alexandre Ribeiro da; Sampaio, Camila Santana Justo Cintra


    To develop a Virtual Learning Environment (VLE) aiming at the training of nursing team workers and emergency vehicle drivers in Basic Life Support (BLS) to attend Cardiorespiratory arrest, and to evaluate the quality of its contents among specialists in the area of Emergency and Urgent care. Applied research of technological development. The methodology used was based on the Instructional Design Model (ADDIE), which structures the teaching-learning planning in different stages (analysis, design, development, implementation and evaluation). The VLE was composed of texts elaborated from bibliographic research, links, edited video from a simulation scenario in the laboratory and questions to evaluate the fixation of the content, organized in modules. After its development, it was evaluated as adequate to satisfy the needs of the target public, by eight expert judges, which was made available for electronic access. The VLE has potential as a tool for training and qualification in BLS, as it can be easily integrated with other pedagogical approaches and strategies with active methodologies. Desenvolver um Ambiente Virtual de Aprendizagem (AVA) visando à capacitação de trabalhadores da equipe de enfermagem e condutores de veículo de emergência em Suporte Básico de Vida (SBV) no atendimento à Parada Cardiorrespiratória, e avaliar a qualidade do seu conteúdo junto a especialistas na área de Urgência e Emergência. Pesquisa aplicada, de produção tecnológica. A metodologia utilizada foi baseada no Modelo de Design Instrucional (ADDIE), que estrutura o planejamento de ensino-aprendizagem em estágios distintos (analysis, design, development, implementation and evaluation). O AVA foi composto por textos elaborados a partir de pesquisa bibliográfica, links, vídeo construído a partir de um cenário de simulação em laboratório e questões para avaliar a fixação do conteúdo, organizados em módulos. Após a sua construção, foi avaliado como adequado para

  7. Differential role for ERK2 in anoxia-induced activation of transcription and translation of Hsp70 in NIH 3T3 cells

    DEFF Research Database (Denmark)

    Ossum, Carlo; Lauritsen, Anders N.; Karottki, Dorina Gabriela


    transcription and translation of Hsp70 during recovery from chemical anoxia and the role of the extracellular signal regulated kinase ERK2 in this induction of Hsp70. 10 mM azide for 30 minutes (chemical anoxia) significantly inhibited the activity of ERK2 (measured as phospho-ERK) but the ERK-2 activity...... is rapidly increased in a MEK-independen manner, when azide is washed out of the cells. Chemical anoxia and overnight recovery induced Hsp70 expression (analyzed by Western blotting) and this was inhibited by actinomycin D as well as by cycloheximide showing that induction of both translation...

  8. P53 modulation of radiation induced G1 arrests and intrinsic radiation sensitivity

    International Nuclear Information System (INIS)

    Mei Su; Pardo, F.S.


    Objective: Wild type p53 functions as a cell cycle control protein at the G1/S cell cycle interface. DNA damage following exposure to ionizing radiation result in increases in p53 expression concomitant with cell cycle arrest at the G1/S boundary. We sought to investigate the relationship between p53 expression and cell cycle arrest in REC transfected with p53 expression vectors. Methods: REC were transfected with both mutant and wild type p53 expression vector by a calcium phosphate-based method. Transfected cellular populations, consisting of 3-6 clones isolated from the transfection studies, were used for subsequent analyses. Radiation survival assays measured clonogenic survival following exposure to 250 kVp x-rays under oxic conditions. The data were fitted to the linear quadratic model of cell survival, emphasizing D and SF2 as parameters. Expression of p53 protein was determined in transfected cellular populations both prior to and following doses of 0,2,5,10, and 15 Gy. Flow cytometric techniques assessed radiation-induced cell cycle changes for up to 48 hours following irradiation, with particular emphasis on the kinetics of both the G1/S and G2/M cell cycle transitions. Results: Cellular populations transfected with mutant p53 express levels of p53 approximately 10-fold higher than untransfected or mock-transfected counterparts. REC transfected with wild type p53 were more sensitive to ionizing radiation in vitro (2-tailed test, SF2, MID). REC transfected with wild type p53, as well as those that are untransfected or mock-transfected, reveal dose dependent arrests at the G1/S interface concomitant with modest elevations in p53 protein production. Cells transfected with mutant p53 demonstrate a lack of arrest following irradiation without significant upregulation of overall p53 protein production. REC transfected with a human mutant p53 allele, reveal increases in resistance to ionizing radiation in vitro (p<.05, SF2,MID). Conclusion: Following exposure to

  9. Association of prenatal and childhood blood lead concentrations with criminal arrests in early adulthood.

    Directory of Open Access Journals (Sweden)

    John Paul Wright


    Full Text Available Childhood lead exposure is a purported risk factor for antisocial behavior, but prior studies either relied on indirect measures of exposure or did not follow participants into adulthood to examine the relationship between lead exposure and criminal activity in young adults. The objective of this study was to determine if prenatal and childhood blood lead concentrations are associated with arrests for criminal offenses.Pregnant women were recruited from four prenatal clinics in Cincinnati, Ohio if they resided in areas of the city with a high concentration of older, lead-contaminated housing. We studied 250 individuals, 19 to 24 y of age, out of 376 children who were recruited at birth between 1979 and 1984. Prenatal maternal blood lead concentrations were measured during the first or early second trimester of pregnancy. Childhood blood lead concentrations were measured on a quarterly and biannual basis through 6.5 y. Study participants were examined at an inner-city pediatric clinic and the Cincinnati Children's Hospital Medical Center in Cincinnati, Ohio. Total arrests and arrests for offenses involving violence were collected from official Hamilton County, Ohio criminal justice records. Main outcomes were the covariate-adjusted rate ratios (RR for total arrests and arrests for violent crimes associated with each 5 microg/dl (0.24 micromol/l increase in blood lead concentration. Adjusted total arrest rates were greater for each 5 microg/dl (0.24 micromol/l increase in blood lead concentration: RR = 1.40 (95% confidence interval [CI] 1.07-1.85 for prenatal blood lead, 1.07 (95% CI 0.88-1.29 for average childhood blood lead, and 1.27 (95% CI 1.03-1.57 for 6-year blood lead. Adjusted arrest rates for violent crimes were also greater for each 5 microg/dl increase in blood lead: RR = 1.34 (95% CI 0.88-2.03 for prenatal blood lead, 1.30 (95% CI 1.03-1.64 for average childhood blood lead, and 1.48 (95% CI 1.15-1.89 for 6-year blood lead.Prenatal and

  10. [Chronobiology of out-of-hospital cardiac arrest in Galicia with semi-automatic external defibrillators]. (United States)

    Soto-Araujo, L; Costa-Parcero, M; López-Campos, M; Sánchez-Santos, L; Iglesias-Vázquez, J A; Rodríguez-Núñez, A


    To analyze the chronobiological variations of out-hospital cardiac arrest in which an automated external defibrillator was used in Galicia. Descriptive retrospective study of the cardiac arrest attended by the Emergency Medical Service in which an automated external defibrillator was in use during a period of 5 years (2007-2011). An Utstein style database was used. The sex, age, date and hour of the event, location, cardiac arrest attended, beginning of resuscitation by the professional, first monitored rhythm, emergency team activation time and care, endotracheal intubation, and recovery of spontaneous circulation were studied as independent variables. A total of 2,005 cases (0.14/1,000 population-year) was recorded. Time slot with more frequency of cardiac arrest: between 09-11 hrs (18.4%). Months with more cases: January (10.4%) and December (9.8%). It was significantly more probable that the cardiac arrest occurred in the home between 00-08 hrs, and in the street between 08-16 hrs. Asystole was more frequent in the night period (00-08 hrs), whereas the shockable rhythm was in the evening (16-00 hrs). There is more probability of death after cardiac arrest between 00-08 hrs, with recovery of spontaneous circulation being more probable between 16-00 hrs. The time between the emergency team activation and time care was longer in night schedule. In Galicia, cardiac arrest is more frequent in the winter months and in morning schedule. There is a circadian distribution of the cardiac arrest and the rhythm detected at the time of the first assistance, with asystole being more common in night schedule and the shockable rhythm in the evening. The chronobiology of the cardiac arrest should be taken into account in order to organize the distribution and the schedule of the healthcare resources. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. Dynamical principles of cell-cycle arrest: Reversible, irreversible, and mixed strategies (United States)

    Pfeuty, Benjamin


    Living cells often alternate between proliferating and nonproliferating states as part of individual or collective strategies to adapt to complex and changing environments. To this aim, they have evolved a biochemical regulatory network enabling them to switch between cell-division cycles (i.e., oscillatory state) and cell-cycle arrests (i.e., steady state) in response to extracellular cues. This can be achieved by means of a variety of bifurcation mechanisms that potentially give rise to qualitatively distinct cell-cycle arrest properties. In this paper, we study the dynamics of a minimal biochemical network model in which a cell-division oscillator and a differentiation switch mutually antagonize. We identify the existence of three biologically plausible bifurcation scenarios organized around a codimension-four swallowtail-homoclinic singularity. As a result, the model exhibits a broad repertoire of cell-cycle arrest properties in terms of reversibility of these arrests, tunability of interdivision time, and ability to track time-varying signals. This dynamic versatility would explain the diversity of cell-cycle arrest strategies developed in different living species and functional contexts.

  12. Growth Arrest on Inhibition of Nonsense-Mediated Decay Is Mediated by Noncoding RNA GAS5

    Directory of Open Access Journals (Sweden)

    Mirna Mourtada-Maarabouni


    Full Text Available Nonsense-mediated decay is a key RNA surveillance mechanism responsible for the rapid degradation of mRNAs containing premature termination codons and hence prevents the synthesis of truncated proteins. More recently, it has been shown that nonsense-mediated decay also has broader significance in controlling the expression of a significant proportion of the transcriptome. The importance of this mechanism to the mammalian cell is demonstrated by the observation that its inhibition causes growth arrest. The noncoding RNA growth arrest specific transcript 5 (GAS5 has recently been shown to play a key role in growth arrest induced by several mechanisms, including serum withdrawal and treatment with the mTOR inhibitor rapamycin. Here we show that inhibition of nonsense-mediated decay in several human lymphocyte cell lines causes growth arrest, and siRNA-mediated downregulation of GAS5 in these cells significantly alleviates the inhibitory effects observed. These observations hold true for inhibition of nonsense-mediated decay both through RNA interference and through pharmacological inhibition by aminoglycoside antibiotics gentamycin and G418. These studies have important implications for ototoxicity and nephrotoxicity caused by gentamycin and for the proposed use of NMD inhibition in treating genetic disease. This report further demonstrates the critical role played by GAS5 in the growth arrest of mammalian cells.

  13. TGEV nucleocapsid protein induces cell cycle arrest and apoptosis through activation of p53 signaling. (United States)

    Ding, Li; Huang, Yong; Du, Qian; Dong, Feng; Zhao, Xiaomin; Zhang, Wenlong; Xu, Xingang; Tong, Dewen


    Our previous studies showed that TGEV infection could induce cell cycle arrest and apoptosis via activation of p53 signaling in cultured host cells. However, it is unclear which viral gene causes these effects. In this study, we investigated the effects of TGEV nucleocapsid (N) protein on PK-15 cells. We found that TGEV N protein suppressed cell proliferation by causing cell cycle arrest at the S and G2/M phases and apoptosis. Characterization of various cellular proteins that are involved in regulating cell cycle progression demonstrated that the expression of N gene resulted in an accumulation of p53 and p21, which suppressed cyclin B1, cdc2 and cdk2 expression. Moreover, the expression of TGEV N gene promoted translocation of Bax to mitochondria, which in turn caused the release of cytochrome c, followed by activation of caspase-3, resulting in cell apoptosis in the transfected PK-15 cells following cell cycle arrest. Further studies showed that p53 inhibitor attenuated TGEV N protein induced cell cycle arrest at S and G2/M phases and apoptosis through reversing the expression changes of cdc2, cdk2 and cyclin B1 and the translocation changes of Bax and cytochrome c induced by TGEV N protein. Taken together, these results demonstrated that TGEV N protein might play an important role in TGEV infection-induced p53 activation and cell cycle arrest at the S and G2/M phases and apoptosis occurrence. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Therapeutic Hypothermia Reduces Oxidative Damage and Alters Antioxidant Defenses after Cardiac Arrest (United States)

    Hackenhaar, Fernanda S.; Medeiros, Tássia M.; Heemann, Fernanda M.; Behling, Camile S.; Putti, Jordana S.; Mahl, Camila D.; Verona, Cleber; da Silva, Ana Carolina A.; Guerra, Maria C.; Gonçalves, Carlos A. S.; Oliveira, Vanessa M.; Riveiro, Diego F. M.; Vieira, Silvia R. R.


    After cardiac arrest, organ damage consequent to ischemia-reperfusion has been attributed to oxidative stress. Mild therapeutic hypothermia has been applied to reduce this damage, and it may reduce oxidative damage as well. This study aimed to compare oxidative damage and antioxidant defenses in patients treated with controlled normothermia versus mild therapeutic hypothermia during postcardiac arrest syndrome. The sample consisted of 31 patients under controlled normothermia (36°C) and 11 patients treated with 24 h mild therapeutic hypothermia (33°C), victims of in- or out-of-hospital cardiac arrest. Parameters were assessed at 6, 12, 36, and 72 h after cardiac arrest in the central venous blood samples. Hypothermic and normothermic patients had similar S100B levels, a biomarker of brain injury. Xanthine oxidase activity is similar between hypothermic and normothermic patients; however, it decreases posthypothermia treatment. Xanthine oxidase activity is positively correlated with lactate and S100B and inversely correlated with pH, calcium, and sodium levels. Hypothermia reduces malondialdehyde and protein carbonyl levels, markers of oxidative damage. Concomitantly, hypothermia increases the activity of erythrocyte antioxidant enzymes superoxide dismutase, glutathione peroxidase, and glutathione S-transferase while decreasing the activity of serum paraoxonase-1. These findings suggest that mild therapeutic hypothermia reduces oxidative damage and alters antioxidant defenses in postcardiac arrest patients. PMID:28553435

  15. Main Complications of Mild Induced Hypothermia after Cardiac Arrest: A Review Article

    Directory of Open Access Journals (Sweden)

    Hassan Soleimanpour


    Full Text Available The aim of the present study is to assess the complications of mild induced hypothermia (MIH in patients with cardiac arrest. Presently, based on the guidelines of the American heart Association, MIH following successful cardiopulmonary resuscitation (CPR in unconscious adult patients due to ventricular fibrillation (VF with out-of-hospital cardiac arrest (OOHCA is essential and required. However, MIH could be associated with complications in Patients with cardiac arrest. Studies conducted on the precautions and care following cardiac arrest and MIH were included. Valid scientific data bases were used for data collection. The obtained results from different studies revealed that mild MIH could be associated with numerous complications and the knowledge and awareness of the medical staff from the complications is required to guarantee successful therapeutic approaches in MIH following cardiac arrest which is a novel medical facility with different styles and complications. Overall, further future studies are required to improve the quality of MIH, to increase survival and to decrease complications rates.


    Directory of Open Access Journals (Sweden)

    Agung Warsito


    Full Text Available Electric energy has been transmiting from power station to end user with transmission and distribution lines.Lightning strokes are problems that occure in transmission and distribution lines and make them fault when theelectric energy were transmited. Surge Diverter or Lightning Arrester has been installing to reduce these faults.In this paper the simulation of lightning stroke and lightning arrester performance on distribution lines 20 kVwere done using EMTP (Electromagnetic Transient Program. Some parameters such us impuls voltage andincreasing voltage on distribution line was inverstigated. As case study in this simulation, Mojosongo 1 mainfeeder 20 kV three phase lines were used.The simulation results show that the lightning stroke 20 kA in By1-61-61E-84-9I on S phase at 0,1 ms, makevoltage on S phase was increased about 1,3054 MV. For R phase and T phase will increase of induced voltagewere 0.79539 MV and 0.80484 MV. We also show the performance of MOV Arrester (Metal Oxide Varistor inovercoming lightning stroke trouble, where arrester can decrease voltage up to 15.198 kV on S phase, while atR phase and T phase arrester can decrease voltage up to 11.375 kV and 13.616 kV.

  17. Novel mutations in genes encoding subcortical maternal complex proteins may cause human embryonic developmental arrest. (United States)

    Wang, Xueqian; Song, Di; Mykytenko, Dmytro; Kuang, Yanping; Lv, Qifeng; Li, Bin; Chen, Biaobang; Mao, Xiaoyan; Xu, Yao; Zukin, Valery; Mazur, Pavlo; Mu, Jian; Yan, Zheng; Zhou, Zhou; Li, Qiaoli; Liu, Suying; Jin, Li; He, Lin; Sang, Qing; Sun, Zhaogui; Dong, Xi; Wang, Lei


    Successful human reproduction initiates from normal gamete formation, fertilization and early embryonic development. Abnormalities in any of these steps will lead to infertility. Many infertile patients undergo several failures of IVF and intracytoplasmic sperm injection (ICSI) cycles, and embryonic developmental arrest is a common phenotype in cases of recurrent failure of IVF/ICSI attempts. However, the genetic basis for this phenotype is poorly understood. The subcortical maternal complex (SCMC) genes play important roles during embryonic development, and using whole-exome sequencing novel biallelic mutations in the SCMC genes TLE6, PADI6 and KHDC3L were identified in four patients with embryonic developmental arrest. A mutation in TLE6 was found in a patient with cleaved embryos that arrested on day 3 and failed to form blastocysts. Two patients with embryos that arrested at the cleavage stage had mutations in PADI6, and a mutation in KHDC3L was found in a patient with embryos arrested at the morula stage. No mutations were identified in these genes in an additional 80 patients. These findings provide further evidence for the important roles of TLE6, PADI6 and KHDC3L in embryonic development. This work lays the foundation for the genetic diagnosis of patients with recurrent IVF/ICSI failure. Copyright © 2018 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Rotavirus replication is correlated with S/G2 interphase arrest of the host cell cycle.

    Directory of Open Access Journals (Sweden)

    Selene Glück

    Full Text Available In infected cells rotavirus (RV replicates in viroplasms, cytosolic structures that require a stabilized microtubule (MT network for their assembly, maintenance of the structure and perinuclear localization. Therefore, we hypothesized that RV could interfere with the MT-breakdown that takes place in mitosis during cell division. Using synchronized RV-permissive cells, we show that RV infection arrests the cell cycle in S/G2 phase, thus favoring replication by improving viroplasms formation, viral protein translation, and viral assembly. The arrest in S/G2 phase is independent of the host or viral strain and relies on active RV replication. RV infection causes cyclin B1 down-regulation, consistent with blocking entry into mitosis. With the aid of chemical inhibitors, the cytoskeleton network was linked to specific signaling pathways of the RV-induced cell cycle arrest. We found that upon RV infection Eg5 kinesin was delocalized from the pericentriolar region to the viroplasms. We used a MA104-Fucci system to identify three RV proteins (NSP3, NSP5, and VP2 involved in cell cycle arrest in the S-phase. Our data indicate that there is a strong correlation between the cell cycle arrest and RV replication.

  19. Apathy and Cognitive Deficits in Patients with Transient Global Ischemia After Cardiac Arrest. (United States)

    Frisch, Stefan; Thiel, Friederike; Schroeter, Matthias L; Jentzsch, Regina Tina


    Despite the extensive literature on cognitive deficits in the course of transient global ischemia after cardiac arrest with delayed resuscitation, apathy has been studied less frequently and systematically. We aimed to evaluate the frequency of apathy, defined as changes in drive or lack of motivation, and its relation to cognition as well as depression in people with transient global ischemia after cardiac arrest. In a retrospective study using the clinical data of 38 cardiac arrest survivors, we analyzed the frequency and severity of deficits in four cognitive domains (attention, memory spans, long-term memory, and executive functions) as well as apathy. As in previous studies, long-term memory problems were predominant, but occurred rarely in isolation. Problems in drive were frequent and correlated with the severity of deficits in all cognitive domains except memory spans (and executive functions only as a trend). Influences of apathy were independent of the presence of a depressive syndrome. Transient global ischemia after cardiac arrest generally leads to a broad pattern of cognitive decline with predominating memory deficits. Apathy is a frequent sequela and is associated with cognitive deficits, independent of depression. Studies investigating the cognitive profile after cardiac arrest should account for modulating influences of apathy.

  20. Surgical management of arrested hydrocephalus: Case report, literature review, and 18-month follow-up. (United States)

    Hong, Jennifer; Barrena, Benjamin G; Lollis, S Scott; Bauer, David F


    Arrested hydrocephalus is stable ventriculomegaly without evidence of neurologic deterioration or symptoms. Management of arrested hydrocephalus in asymptomatic adults is controversial, with little clinical data. This case highlights the potential for decompensation in adults with arrested hydrocephalus and reviews the literature regarding pathophysiology and management of this clinical entity. A 39 year-old gentleman with arrested hydrocephalus incidentally found during work-up for new-onset seizure and managed conservatively for ten years presented with increasing headache, memory loss, gait instability and urinary and fecal incontinence. Stable massive triventriculomegaly was documented on serial brain imaging, and ophthalmologic exam revealed no papilledema. The patient underwent endoscopic third ventriculostomy with immediate post-operative improvement of headache, resolution of incontinence, and cessation of seizures. At 15 months after surgery, neuropsychiatric testing demonstrated improvement in visuomotor skills, problem solving, verbal fluency and cognitive flexibility compared to his pre-operative baseline. At 18 months after surgery he remained seizure free with full continence and significant improvement in headaches. Early recognition of arrested hydrocephalus and its potential for decompensation may prompt surgical treatment and prevent neurologic deterioration. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. L1 arrest, daf-16/FoxO and nonautonomous control of post-embryonic development. (United States)

    Kaplan, Rebecca E W; Baugh, L Ryan


    Post-embryonic development is governed by nutrient availability. L1 arrest, dauer formation and aging illustrate how starvation, anticipation of starvation and caloric restriction have profound influence on C. elegans development, respectively. Insulin-like signaling through the Forkhead box O transcription factor daf-16/FoxO regulates each of these processes. We recently reported that ins-4, ins-6 and daf-28 promote L1 development from the intestine and chemosensory neurons, similar to their role in dauer development. daf-16 functions cell-nonautonomously in regulation of L1 arrest, dauer development and aging. Discrepancies in daf-16 sites of action have been reported in each context, but the consensus implicates epidermis, intestine and nervous system. We suggest technical limitations of the experimental approach responsible for discrepant results. Steroid hormone signaling through daf-12/NHR is known to function downstream of daf-16 in control of dauer development, but signaling pathways mediating cell-nonautonomous effects of daf-16 in aging and L1 arrest had not been identified. We recently showed that daf-16 promotes L1 arrest by inhibiting daf-12/NHR and dbl-1/TGF-β Sma/Mab signaling, two pathways that promote L1 development in fed larvae. We will review these results on L1 arrest and speculate on why there are so many signals and signaling centers regulating post-embryonic development.

  2. Abnormal mitosis triggers p53-dependent cell cycle arrest in human tetraploid cells. (United States)

    Kuffer, Christian; Kuznetsova, Anastasia Yurievna; Storchová, Zuzana


    Erroneously arising tetraploid mammalian cells are chromosomally instable and may facilitate cell transformation. An increasing body of evidence shows that the propagation of mammalian tetraploid cells is limited by a p53-dependent arrest. The trigger of this arrest has not been identified so far. Here we show by live cell imaging of tetraploid cells generated by an induced cytokinesis failure that most tetraploids arrest and die in a p53-dependent manner after the first tetraploid mitosis. Furthermore, we found that the main trigger is a mitotic defect, in particular, chromosome missegregation during bipolar mitosis or spindle multipolarity. Both a transient multipolar spindle followed by efficient clustering in anaphase as well as a multipolar spindle followed by multipolar mitosis inhibited subsequent proliferation to a similar degree. We found that the tetraploid cells did not accumulate double-strand breaks that could cause the cell cycle arrest after tetraploid mitosis. In contrast, tetraploid cells showed increased levels of oxidative DNA damage coinciding with the p53 activation. To further elucidate the pathways involved in the proliferation control of tetraploid cells, we knocked down specific kinases that had been previously linked to the cell cycle arrest and p53 phosphorylation. Our results suggest that the checkpoint kinase ATM phosphorylates p53 in tetraploid cells after abnormal mitosis and thus contributes to proliferation control of human aberrantly arising tetraploids.

  3. Determination of conditional probability of dynamic axial crack arrest for conventionally-rolled, lower-toughness linepipe materials

    Energy Technology Data Exchange (ETDEWEB)

    Rudland, D.; Wilkowski, G. [Engineering Mechanics Corp. of Columbus, Columbus, OH (United States); Kawaguchi, S.; Hagiwara, N. [Tokyo Gas Co. Ltd., Tokyo (Japan)


    An analytic procedure to predict the conditional probability of dynamic ductile axial crack arrest within a pipe joint length operating above brittle-to-ductile transition temperatures was presented. The analysis assumed that the absolute probability of a fracture event occurring was the probability of the rupture event multiplied by the conditional probability of arrest within a pipe joint. The model used the Battelle 2-curve approach with a Dugdale plastic-zone correction to predict the arrest length given the actual material toughness relative to the minimum arrest toughness. Data from previous experiments were used to develop statistical parameters that were then used in a Monte Carlo analysis. An iterative approach was used to determine the tangency point between curves that represented the point where the decompression velocity and the fracture speed were equal for a given pressure. Random variables included material toughness; minimum toughness for arrest; and adjustment for arrest within 1 pipe joint. The model was then calibrated for low-toughness and low-grade pipeline materials. Case studies were presented to demonstrate variations of the conditional probability of arrest within various pipeline operating conditions. Results showed the effects of material variability on the conditional probabilities of arrest with a crack length greater than 1 pipe joint. It was concluded that the procedure can be used to predict the conditional probabilities of crack arrest. 5 refs., 7 figs.

  4. Disturbances of sensation occasioned by experimental arrest of blood flow

    Directory of Open Access Journals (Sweden)

    Alfred Auersperg


    Full Text Available Disturbances of sensation in the hand were studied during and after experimental arrest of circulation to the arm. Blockage of circulation was performed as outlined by Lewis and Pochin, by putting the cuff of a sphygmomanometer on the upper arm and bringing the pressure rapidly up to 200 mm/Hg. The experiments listed below were intended to demonstrate the variability of a central reaction brought about by fairly definite disturbances of the ischaemic periphery. All experiments were made on the present writers and repeated on nine other subjects, none of whom had systolic pressure reaching 150 mm/Hg. I - Blockage of circulation in both arms led to symmetrical phenomena in both hands (thermal paresthesias, tingling and hyposthesia, both under symmetrical experimental circumstances, and under the following variations: So long as the cuff pressure on both arms was above the systolic blood pressure, differences as great as 300 mm/Hg in one cuff and 150 mm in the other did not alter the symmetry of the effects. Neither was symmetry and synchronism of paresthesias affected when compression on one side preceded equal compression on the other up to 20 seconds. II - When a punctate pressure is applied to the paresthetic field the paresthesias disappear around that point and the latter is clearly brought out from the indifferent background produced in the area of depressed skin. On the basis of Kugelberg's findings, it seems that this occurs because the impulses caused by pressure have a higher frequency and substitute the spontaneous abnormal discharges of the ischaemic nerve fibers. III - Repeated mechanical stimulation of a fingertip during the experiment failed to show any influence on sensory (touch thresholds, in contrast, therefore, to what would be expected on the basis of the physiologic experiments which show rapid fatigue of ischaemic structures. IV - In contrast to what might be expected from the intense changes undergone by receptors in the

  5. Therapeutic hypothermia after cardiac arrest in a patient with systemic sclerosis and Raynaud phenomenon. (United States)

    Bakal, Keren; Danckers, Mauricio; Denson, Joshua L; Sauthoff, Harald


    Therapeutic hypothermia favorably impacts neurologic outcomes in patients after cardiopulmonary arrest, although the appropriate target temperature is less clear. Its safety profile in patients with systemic sclerosis (SSc) and Raynaud phenomenon (RP), who may be at increased risk for ischemic complications, has not been addressed in the literature, to our knowledge. Digital lesions are commonly seen in patients with SSc, and cold-induced myocardial ischemia has also been reported. We describe a case of a man with SSc, RP, and digital ulcers who underwent therapeutic hypothermia after cardiopulmonary arrest. He regained full neurologic function, and except for digital necrosis, no hypothermia-associated adverse events were observed. Other risk factors for ischemia, such as cocaine use, may have contributed to the development of the digital necrosis. However, clinicians should be aware of the risk for ischemic complications in patients with SSc and RP when considering the appropriate target temperature after cardiopulmonary arrest.

  6. Assessment of risks for employees of France Telecom regarding overvoltage arresters containing radio-elements

    International Nuclear Information System (INIS)

    Thomassin, A.; Metz, C.; Rannou, A.


    As a great number of overvoltage arresters used by France Telecom to protect its telecommunication network against disturbing voltages (notably lightning) contain radio-elements, this report aims at assessing dose levels and associated risks for employees exposed to radioactive overvoltage arrester when setting them up, exploiting installations containing such arresters, or when removing them. After a presentation of these devices, a modelling of activities and geometries is proposed, as well as computation tools. Different scenarios and exposure situations are considered. As far as risks are concerned, after a recall on cancers and ionizing radiation, and on the exposure of France Telecom employees, the report comments the knowledge on radio-induced cancers; notably breast cancer, skin cancer, and mouth and pharynx cancers

  7. Effect of caffeine on radiation-induced mitotic delay: delayed expression of G2 arrest

    International Nuclear Information System (INIS)

    Rowley, R.; Zorch, M.; Leeper, D.B.


    In the presence of 5 mM caffeine, irradiated (1.5 Gy) S and G 2 cells progressed to mitosis in register and without arrest in G 2 . Caffeine (5 mM) markedly reduced mitotic delay even after radiation doses up to 20 Gy. When caffeine was removed from irradiated (1.5 Gy) and caffeine-treated cells, a period of G 2 arrest followed, similar in length to that produced by radiation alone. The arrest expressed was independent of the duration of the caffeine treatment for exposures up to 3 hr. The similarity of the response to the cited effects of caffeine on S-phase delay suggests a common basis for delay induction in S and G 2 phases

  8. ECMO as an effective rescue therapeutic for fulminant myocarditis complicated with refractory cardiac arrest. (United States)

    Li, Ya-Ting; Yang, Li-Fen; Chen, Zhuang-Gui; Pan, Li; Duan, Meng-Qi; Hu, Yan; Zhou, Cheng-Bin; Guo, Yu-Xiong


    Fulminant myocarditis (FM) is a life-threatening disease in children. With a rapid, progressive course of deterioration, it causes refractory cardiorespiratory failure even with optimal clinical intervention. We present the case of a 9-year-old girl with FM complicated by cardiogenic shock, malignant arrhythmia, and refractory cardiac arrest. She received effective cardiopulmonary resuscitation, therapeutic hypothermia, and other supportive treatments. However, the patient rapidly worsened into pulseless ventricular tachycardia and refractory cardiac arrest. Therefore, we performed extracorporeal membrane oxygenation (ECMO) to establish spontaneous circulation after the failure of standard resuscitation measures. The girl recovered with intact cardiac and neurocognitive functions after continued ECMO treatment for 221 hours. Therefore, ECMO is an effective rescue therapeutics for FM, especially when complicated with refractory cardiac arrest.

  9. Astaxanthin Inhibits Proliferation and Induces Apoptosis and Cell Cycle Arrest of Mice H22 Hepatoma Cells. (United States)

    Shao, Yiye; Ni, Yanbo; Yang, Jing; Lin, Xutao; Li, Jun; Zhang, Lixia


    BACKGROUND It is widely recognized that astaxanthin (ASX), a member of the carotenoid family, has strong biological activities including antioxidant, anti-inflammation, and immune-modulation activities. Previous studies have confirmed that ASX can effectively inhibit hepatoma cells in vitro. MATERIAL AND METHODS MTT was used to assay proliferation of mice H22 cells, and flow cytometry was used to determine apoptosis and cell cycle arrest of H22 cells in vitro and in vivo. Moreover, anti-tumor activity of ASX was observed in mice. RESULTS ASX inhibited the proliferation of H22 cells, promoted cell necrosis, and induced cell cycle arrest in G2 phase in vitro and in vivo. CONCLUSIONS This study indicated that ASX can inhibit proliferation and induce apoptosis and cell cycle arrest in mice H22 hepatoma cells in vitro and in vivo.

  10. Return to Work in Out-of-Hospital Cardiac Arrest Survivors

    DEFF Research Database (Denmark)

    Kragholm, Kristian; Wissenberg, Mads; Mortensen, Rikke Normark


    reported to the Danish Cardiac Arrest Register since 2001. During 2001-2011, we identified 4354 patients employed before arrest among 12 332 working-age patients (18-65 years), of whom 796 survived to day 30. Among 796 survivors (median age, 53 years [quartile 1-3, 46-59 years]; 81.5% men), 610 (76...... over time (66.1% in 2001-2005 versus 78.1% in 2006-2011; P=0.002). In multivariable Cox regression analysis, factors associated with return to work with ≥6 months of sustainable employment were as follows: (1) arrest during 2006-2011 versus 2001-2005, hazard ratio (HR), 1.38 (95% CI, 1.05-1.82); (2...

  11. Romantic Partners' Influence on Men's Likelihood of Arrest in Early Adulthood. (United States)

    Capaldi, Deborah M; Kim, Hyoun K; Owen, Lee D


    Female romantic partners' influence on official crime occurrence for men across a 12-year period in early adulthood was examined within a comprehensive dynamic prediction model including both social learning and social control predictors. We hypothesized that relationship stability, rather than attachment to partner, would be associated with reduced likelihood of crime, whereas women's antisocial behavior would be a risk factor, along with deviant peer association. Models were tested on a sample of at-risk men [the Oregon Youth Study (OYS)] using zero-inflated Poisson (ZIP) modeling predicting to 1) arrest persistence (class and count) and 2) arrest onset class. Findings indicated that women's antisocial behavior was predictive of both onset and persistence of arrests for men, and deviant peer association was predictive of persistence. Relationship stability was protective against persistence.

  12. [Consideration of early rehabilitation in the treatment of post-cardiac arrest syndrome]. (United States)

    Kurihara, Masaki; Ogasawara, Sadanobu; Kadowaki, Aya; Onizuka, Shouzaburou; Samejima, Mituhiro


    Resumption of spontaneous circulation (ROSC) after cardiac arrest is an unnatural pathophysiological state. In 2008, ILCOR has proposed "post-cardiac arrest syndrome (PCAS)". Clinicians must focus on treating to reverse the pathophysiological manifestations of PCAS in bed. Immobility, deconditioning, and weakness are common problems in patients with critical illness. Therapeutic strategies have to be identified to give patients after ROSC the best chance for survival with good neurological function. Concerning the beneficial effects of early mobilization after stroke, and the efficacy of a strategy for whole-body rehabilitation in the earliest days of critical illness on functional outcomes, the intervention of early rehabilitation care by an interdisciplinary team seems to contribute to good long-time outcome of post-cardiac arrest patients.

  13. Estimation of the Frequency of Instantaneous Voltage Drops Dependent on Arrangement of Line Surge Arresters (United States)

    Kawamura, Hironao; Kozuka, Masahiro; Itamoto, Naoki; Shinjo, Kazuo; Ishii, Masaru

    Lightning faults on transmission lines often cause instantaneous voltage drops in power systems. Influences of instantaneous voltage drops become increasingly serious in high technology industries etc. As countermeasures of instantaneous voltage drops, uninterruptible power supplies (UPS) are employed. On the other hand, line surge arresters are installed on transmission lines increasingly as one of the effective countermeasures of double-circuit faults caused by lightning strokes. Additionally, the arresters are effective as one of the reduction methods for the frequency of instantaneous voltage drops. In this paper, the frequency of instantaneous voltage drops reduced by installation of line surge arresters on transmission lines is estimated by employing EMTP analysis. Also, the accuracy of the method in estimating the frequency of instantaneous voltage drops in power systems is evaluated through comparison with experience.

  14. Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base

    Energy Technology Data Exchange (ETDEWEB)

    Jalali, Elnaz; Tadinada, Aditya [Dept. of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington (United States)


    Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.

  15. Can ambulance telephone triage using NHS Pathways accurately identify paediatric cardiac arrest? (United States)

    Deakin, Charles D; England, Simon; Diffey, Debbie; Maconochie, Ian


    Most out-of-hospital paediatric cardiac arrests (CA) are not identified until a call is made to the emergency medical services. Accurate identification increases overall survival by enabling immediate ambulance dispatch and delivery of bystander CPR. European ambulance services use a variety of didactic telephone scripts to interrogate the caller and rapidly identify paediatric CA. The performance of these scripts has not been reported. This study aims to evaluate the diagnostic accuracy of the NHS Pathways as a telephone triage tool to identify patients less than 16 years age in cardiac arrest. All emergency calls to South Central Ambulance Service (SCAS) over a 12-month period screened by 'NHS Pathways' v9.04 were identified. All actual or presumed paediatric CAs (telephone triage system for identifying CA. Further work is required to refine telephone triage pathways for paediatric cardiac arrest. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Cardiac Arrest Secondary to Lightning Strike: Case Report and Review of the Literature. (United States)

    Rotariu, Elena L; Manole, Mioara D


    Lightning strike injuries, although less common than electrical injuries, have a higher morbidity rate because of critical alterations of the circulatory system, respiratory system, and central nervous system. Most lightning-related deaths occur immediately after injury because of arrhythmia or respiratory failure. We describe the case of a pediatric patient who experienced cardiorespiratory arrest secondary to a lightning strike, where the Advanced Cardiac Life Support and Basic Life Support chain of survival was well executed, leading to return of spontaneous circulation and intact neurological survival. We review the pathophysiology of lightning injuries, prognostic factors of favorable outcome after cardiac arrest, including bystander cardiopulmonary resuscitation, shockable rhythm, and automatic external defibrillator use, and the importance of temperature management after cardiac arrest.

  17. Sudden Cardiac Arrest due to Brugada Syndrome: a Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    R Soleimanirad


    Full Text Available Brugada Syndrome is a rare cause of sudden cardiac arrest and has a unique ECG pattern. In fact, with ST-segment elevation down sloping in the right precordial leads (v1-v3, RBBB pattern in lateral leads and J-point elevation is revealed. We must notice and avoid trigger factors of this syndrome during general anesthesia. Patient is a 39 old man who attended to emergency department with sudden cardiac arrest and resuscitate. He was transferred to ICU for management of hypoxic ischemic encephalopathy. Complementary studies concluded the diagnosis of Brugada syndrome. We must consider Brugada syndrome within patients with family history of sudden cardiac arrest. Moreover, we must avoid trigger factors of this syndrome such as fever, bradicardia and electrolyte abnormality (specialy Na, Ca abnormalities during general anesthesia and if they appear, we should treat them.

  18. Evaluation of silver diamine fluoride application in children and factors associated with arrested caries survival (United States)

    Chandra, L.; Rahardjo, A.; Adiatman, M.; Darwita, R.; Maharani, D. A.; Callea, M.


    Dental caries is one of the most prevalent infectious diseases in children in Indonesia. Therefore, a solution to overcome caries is needed. Evaluate Silver diamine fluoride (SDF) application for overcoming caries in children and determine factors related to the percentage of arrested caries after SDF application. Cohort study for evaluation and a cross-sectional study; 115 children aged 3-5 years who had active dentin caries were the subjects. Caries risk factors were measured by questionnaires filled out by subjects’ parents. Active caries treated with SDF had odds ratios of 9.9 and 6.8 of being arrested after 3 and 10 months, respectively, when compared with those not treated. Conclusion: SDF is effective in arresting caries and decreasing toothaches suffered by children, thus potentially increasing children’s quality of life.

  19. Caries arrest by topical fluorides in preschool children: 30-month results. (United States)

    Duangthip, D; Wong, M C M; Chu, C H; Lo, E C M


    To compare the effectiveness of three applications of silver diammine fluoride (SDF) solution at yearly interval and three applications of SDF solution or sodium fluoride (NaF) varnish at weekly interval at baseline in arresting active caries in the primary teeth of preschool children. Children aged 3-4 years (n = 371) who had at least one active caries lesion (ICDAS codes 3-6) in their primary teeth were randomly allocated into three groups: Group 1 - annual application of 30% SDF solution; Group 2 - three applications of 30% SDF at weekly intervals; and Group 3 - three applications of 5% NaF varnish at weekly intervals. Follow-up examinations were performed every 6 mo nths by the same masked examiner. After 30 months, 309 (83%) children with 1877 caries lesions remained in the study. For cavitated lesions (ICDAS code 5 or 6), the caries arrest rate of Group 1 (48%) was significantly higher than those of Group 2 (33%) and Group 3 (34%), (p  0.05). Presence of plaque on caries lesion, tooth type and tooth surface type had an influence on caries arrest. Over a 30-month period, annual applications of SDF solution is more effective than three weekly applications of NaF varnish or SDF solution at baseline in arresting active cavitated dentine caries lesions in primary teeth. As annual application of SDF solution was found to be more effective than 3 weekly applications of NaF varnish or SDF solution at baseline in arresting active cavitated dentine caries lesions, the former application protocol is preferred for young children who are available for regular caries arrest treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Cell cycle arrest by a gradient of Dpp signaling during Drosophila eye development

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    Bhattacharya Abhishek


    Full Text Available Abstract Background The secreted morphogen Dpp plays important roles in spatial regulation of gene expression and cell cycle progression in the developing Drosophila eye. Dpp signaling is required for timely cell cycle arrest ahead of the morphogenetic furrow as a prelude to differentiation, and is also important for eye disc growth. The dpp gene is expressed at multiple locations in the eye imaginal disc, including the morphogenetic furrow that sweeps across the eye disc as differentiation initiates. Results Studies of Brinker and Dad expression, and of Mad phosphorylation, establish that there is a gradient of Dpp signaling in the eye imaginal disc anterior to the morphogenetic furrow, predominantly in the anterior-posterior axis, and also Dpp signaling at the margins of the disc epithelium and in the dorsal peripodial membrane. Almost all signaling activity seems to spread through the plane of the epithelia, although peripodial epithelium cells can also respond to underlying disc cells. There is a graded requirement for Dpp signaling components for G1 arrest in the eye disc, with more stringent requirements further anteriorly where signaling is lower. The signaling level defines the cell cycle response, because elevated signaling through expression of an activated Thickveins receptor molecule arrested cells at more anterior locations. Very anterior regions of the eye disc were not arrested in response to activated receptor, however, and evidence is presented that expression of the Homothorax protein may contribute to this protection. By contrast to activated Thickveins, ectopic expression of processed Dpp leads to very high levels of Mad phosphorylation which appear to have non-physiological consequences. Conclusions G1 arrest occurs at a threshold level of Dpp signaling within a morphogen gradient in the anterior eye. G1 arrest is specific for one competent domain in the eye disc, allowing Dpp signaling to promote growth at earlier

  1. Survivors of cardiac arrest with good neurological outcome show considerable impairments of memory functioning. (United States)

    Sulzgruber, Patrick; Kliegel, Andreas; Wandaller, Cosima; Uray, Thomas; Losert, Heidrun; Laggner, Anton N; Sterz, Fritz; Kliegel, Matthias


    Deficits in cognitive function are a well-known dysfunction in survivors of cardiac arrest. However, data concerning memory function in this neurological vulnerable patient collective remain scarce and inconclusive. Therefore, we aimed to assess multiple aspects of retrospective and prospective memory performance in patients after cardiac arrest. We prospectively enrolled 33 survivors of cardiac arrest, with cerebral performance categories (CPC) 1 and 2 and a control-group (n=33) matched in sex, age and educational-level. To assess retrospective and prospective memory performance we administrated 4 weeks after cardiac arrest the "Rey Adult Learning Test" (RAVLT), the "Digit-Span-Backwards Test", the "Logic-Memory Test" and the "Red-Pencil Test". Results indicate an impairment in immediate and delayed free recall, but not in recognition. However, the overall impairment in immediate recall was qualified by analyzing RAVLT performance, showing that patients were only impaired in trials 4 and 5 of the learning sequence. Moreover, working and prospective memory as well as prose recall were worse in cardiac arrest survivors. Cranial computed tomography was available in 61% of all patients (n=20) but there was no specific neurological damage detectable that could be linked to this cognitive impairment. Episodic long-term memory functioning appears to be particularly impaired after cardiac arrest. In contrast, short-term memory storage, even tested via free-call, seems not to be affected. Based on cranial computed tomography we suggest that global brain ischemia rather than focal brain lesions appear to underlie these effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Intestinal ischaemia during cardiac arrest and resuscitation: comparative analysis of extracellular metabolites by microdialysis. (United States)

    Korth, Ulrike; Krieter, Heiner; Denz, Christof; Janke, Christoph; Ellinger, Klaus; Bertsch, Thomas; Henn, Claudia; Klein, Jochen


    Intestinal ischaemia is a major complication of shock syndromes causing translocation of bacteria and endotoxins and multiple organ failure in intensive care patients. The present study was designed to use microdialysis as a tool to monitor intestinal ischaemia after cardiac arrest and resuscitation in pigs. For this purpose, microdialysis probes were implanted in pig jejunal wall, peritoneum, skeletal muscle and brain, and interstitial fluid was obtained during circulatory arrest (induced by ventricular fibrillation) and after return of spontaneous circulation (ROSC). Cardiac arrest for 4 min caused a prolonged (60 min) reduction of blood flow in jejunal wall, muscle and brain as determined by the ethanol technique. This was accompanied by cellular damage in heart muscle and brain as indicated by increased levels of troponin-I and protein S-100, respectively. Plasma levels of glucose, lactate and choline were increased at 15-60 min following cardiac arrest. In contrast, cardiac arrest induced a rapid but variable decrease of interstitial glucose levels in all monitored organs; this decrease was followed by an increase over baseline during reperfusion. In the intestine, lactate, glutamate and choline levels were increased during ischaemia and reperfusion for 60-120 min; intestinal and peritoneal samples yielded parallel changes of lactate levels. Brain and muscle samples showed similar changes as in intestinum and peritoneum except for glutamate, which was increased in brain but not in muscle. We conclude that intestinal ischaemia occurs as a consequence of cardiac arrest and resuscitation and can be monitored by in vivo microdialysis. Comparative analysis by multi-site microdialysis reveals that the intestine is equally or even more sensitive to ischaemia than brain or muscle.

  3. Temporal variation of out-of-hospital cardiac arrests in an equatorial climate

    Directory of Open Access Journals (Sweden)

    Marcus EH Ong


    Full Text Available Marcus EH Ong1, Faith SP Ng2, Susan Yap1, Kok Leong Yong1, Mary A Peberdy3, Joseph P Ornato41Department of Emergency Medicine, Singapore General Hospital, Singapore; 2Clinical Trials and Epidemiology Research Unit (now known as Singapore Clinical Research Institute, Singapore; 3Division of Cardiology, Virginia Commonwealth University – Medical College of Virginia, Richmond, VA, USA; 4Department of Emergency Medicine, Virginia Commonwealth University – Medical College of Virginia, Richmond, VA, USAObjective: We aimed to determine whether there is a seasonal variation of out-of-hospital cardiac arrests (OHCA in an equatorial climate, which does not experience seasonal environmental change.Methods: We conducted an observational prospective study looking at the occurrence of OHCA in Singapore. Included were all patients with OHCA presented to Emergency Departments across the country. We examined the monthly, daily, and hourly number of cases over a threeyear period. Data was analyzed using analysis of variance (ANOVA.Results: From October, 1st 2001 to October, 14th 2004, 2428 patients were enrolled in the study. Mean age for cardiac arrests was 60.6 years with 68.0% male. Ethnic distribution was 69.5% Chinese, 15.0% Malay, 11.0% Indian, and 4.4% Others. There was no significant seasonal variation (spring/summer/fall/winter of events (ANOVA P = 0.71, monthly variation (P = 0.88 or yearly variation (P = 0.26. We did find weekly peaks on Mondays and a circadian pattern with daily peaks from 9–10 am.Conclusions: We did not find any discernable seasonal pattern of cardiac arrests. This contrasts with findings from temperate countries and suggests a climatic influence on cardiac arrest occurrence. We also found that sudden cardiac arrests follow a circadian pattern.Keywords: cardiopulmonary resuscitation, cardiac arrest, seasonal pattern, circadian pattern

  4. An ex vivo study of arrested primary teeth caries with silver diamine fluoride therapy. (United States)

    Mei, May L; Ito, L; Cao, Y; Lo, Edward C M; Li, Q L; Chu, C H


    This ex vivo study compared the physico-chemical structural differences between primary carious teeth biannually treated with silver diamine fluoride (SDF) and carious teeth without such treatment. Twelve carious primary upper-central incisors were collected from 6-year-old children. Six teeth had arrested caries after 24-month biannual SDF applications and 6 had active caries when there was no topical fluoride treatment. The mineral density, elemental contents, surface morphology, and crystal characteristics were assessed by micro-computed tomography (micro-CT), energy-dispersive X-ray spectrometry (EDX), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Micro-CT examination revealed a superficial opaque band approximately 150μm on the arrested cavitated dentinal lesion. This band was limited in the active carious lesion. EDX examination detected a higher intensity of calcium and phosphate of 150μm in the surface zone than in the inner zone, but this zone was restricted in the active cavitated dentinal lesion. SEM examination indicated that the collagens were protected from being exposed in the arrested cavitated dentinal lesion, but were exposed in the active cavitated dentinal lesion. TEM examination suggested that remineralised hydroxyapatites were well aligned in the arrested cavitated dentinal lesion, while those in the active cavitated dentinal lesion indicated a random apatite arrangement. A highly remineralised zone rich in calcium and phosphate was found on the arrested cavitated dentinal lesion of primary teeth with an SDF application. The collagens were protected from being exposed in the arrested cavitated dentinal lesion. Clinical SDF application positively influences dentine remineralisation. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Women's perspectives on the context of violence and role of police in their intimate partner violence arrest experiences. (United States)

    Li, Simiao; Levick, Ani; Eichman, Adelaide; Chang, Judy C


    Intimate partner violence (IPV) accounts for up to 50% of all calls to police. In an effort to standardize arrest criteria, mandatory arrest laws were established. It is unclear whether subsequent increased rates of female arrest are due to greater recognition of female IPV perpetrators or of women acting in self-defense. This study aims to understand the context and consequences of IPV-related arrest from perspectives of women arrested in a single metropolitan area. Semi-structured qualitative interviews were conducted with women arrested and court-ordered to attend IPV education groups at a women's shelter in the Northeast United States. Interviews addressed circumstances surrounding arrest, experience with past violence, and reasoning regarding use of partner violence. Two researchers independently coded transcripts and met to iteratively refine the code and review transcripts for themes. Eighteen women were interviewed. Major themes that emerged were as follows: (a) Women's use of violence occurred within the context of their own victimization; (b) the arrest included a complex interplay between subject, partner, and police; (c) women perceived police arrest decisions to be based on a limited understanding of context; and (d) women experienced both positive and negative consequences of arrest. Many relationships did not fall under the traditional victim/perpetrator construct. Rather, women's use of violence evolved, influenced by prior experiences with violence. More appropriate methods must be developed for making arrest decisions, guiding justice system responses, and developing interventions for couples experiencing IPV. Recognition that women's use of partner violence often represented either a retaliatory or self-defensive gesture within the context of prior victimization suggests that victims' interventions should not only focus on empowerment but also provide skills and strategies to avoid temptation to adopt aggression as a primary method of self

  6. The effects of pre-arrest heparin administration dose for cardiac arrest model using extracorporeal lung and a heart assist (ECLHA) in dogs. (United States)

    Ichinose, Keisuke; Okamoto, Taisuke; Tashiro, Masafumi; Tanimoto, Hironari; Terasaki, Hidenori


    Clinical and experimental studies have shown that marked activation of blood coagulation occurs in cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). Extracorporeal lung and heart assist (ECLHA) is applied in CA patients who cannot be rescued using conventional therapies. We hypothesized that the dose of heparin administered during the pre-arrest period would influence the outcome in a canine model of CA induced by 15 min of normothermia followed by ECLHA, which consists of heparin coating membrane lung and tubing. We therefore investigated the effects of two dose regimes of the pre-arrest heparin for this model. Twelve mongrel female dogs were divided into two groups: a group given 200 U/kg heparin (H200, n=6) and a group given 700 U/kg heparin (H700, n=6), group during pre-arrest period. Normothermic ventricular fibrillation (VF) was induced in all dogs for 15 min, followed by 24h of ECLHA with rapidly induced mild hypothermia (33 degrees C) and 120 h of intensive care. Outcome evaluations included: (1) activated coagulation time (ACT); (2) catecholamine dose; (3) hematocrit (Hct) and platelet count; (4) survival rate; (5) neurological deficit scores (NDS); (6) postmortal macroscopic examination with the exception of the brain. In the H200 group, four dogs died of cardiogenic shock within 28 h. The autopsy revealed extensive patchy hemorrhages in the heart and intestine. In the H700 group, the amount of dopamine was significantly lower (6+/-10mg versus 75+/-41 mg, parrest period even if ECLHA circuit was coated with heparin.

  7. Postoperative Cardiac Arrest after Heart Surgery: Does Extracorporeal Perfusion Support a Paradigm Change in Management?

    Directory of Open Access Journals (Sweden)

    Edward Gologorsky


    Full Text Available Early institution of extracorporeal perfusion support (ECPS may improve survival after cardiac arrest. Two patients sustained unexpected cardiac arrest in the Intensive Care Unit (ICU following cardiac interventions. ECPS was initiated due to failure to restore hemodynamics after prolonged (over 60 minutes advanced cardiac life support (ACLS protocol-guided cardiopulmonary resuscitation. Despite relatively late institution of ECPS, both patients survived with preserved neurological function. This communication focuses on the utility of ECPS in the ICU as a part of resuscitative efforts.

  8. Mutations in the Kv1.5 channel gene KCNA5 in cardiac arrest patients

    DEFF Research Database (Denmark)

    Nielsen, Nathalie H; Winkel, Bo G; Kanters, Jørgen K


    Mutations in one of the ion channels shaping the cardiac action potential can lead to action potential prolongation. However, only in a minority of cardiac arrest cases mutations in the known arrhythmia-related genes can be identified. In two patients with arrhythmia and cardiac arrest, we...... characteristics and drug sensitivity. Both patients also carried a D85N polymorphism in KCNE1, which was neither found to influence the Kv1.5 nor the Kv7.1 channel activity. We conclude that although the two N-terminal Kv1.5 mutations did not show any apparent electrophysiological phenotype, it is possible...

  9. Unanticipated cardiac arrest under spinal anesthesia: An unavoidable mystery with review of current literature. (United States)

    Kumari, Anita; Gupta, Ruchi; Bajwa, Sukhminder Jit Singh; Singh, Amrinder


    Cardiac arrest during anesthesia and perioperative period is a matter of grave concern for any anesthesiologist. But such mishaps have been reported for one reason or the other in the literary sciences. We are reporting the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in two young and healthy patients. Fortunately, these patients were successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. Occurrence of such cases needs timely reporting and exploring all the possible causes of these unusual and possibly avoidable events. The present case reports are an important addition to a series of recently published mishaps that occurred during spinal anesthesia in young and healthy patients.

  10. Public school segregation and juvenile violent crime arrests in metropolitan areas. (United States)

    Eitle, David; Eitle, Tamela McNulty


    Previous research has established an association between residential segregation and violent crime in urban America. Our study examines whether school-based segregation is predictive of arrests of juveniles for violent crimes in U.S. metro areas. Using Census, Uniform Crime Report, and Common Core data for 204 metro areas, a measure of school-based racial segregation, Theil's entropy index, is decomposed into two components: between- and within-district segregation. Findings reveal evidence of a significant interaction term: Within-district segregation is inversely associated with arrests for juvenile violence, but only in metropolitan areas with higher than average levels of between-district segregation.

  11. Strategic Placement of Ambulance Drones for Delivering Defibrillators to Out of Hospital Cardiac Arrest Victims


    Lennartsson, Josefin


    The number of out of hospital cardiac arrest (OHCAs) that occur in Sweden every year is really high and there are very few survivors. When a cardiac arrest happens the heart loses its original rhythm and to find it again the heart needs to be shocked within minutes. There is on going research to see what can be done to improve the survival rate. Publicly accessible defibrillators are one thing that is being implemented. Another solution being considered right now is the possibility of deliver...

  12. Enterocyte Damage: A Piece in the Puzzle of Post-Cardiac Arrest Syndrome. (United States)

    Piton, Gaël; Belin, Nicolas; Barrot, Loïc; Belon, François; Cypriani, Benoit; Navellou, Jean-Christophe; Capellier, Gilles


    Cardiac arrest is considered to be a cause of small bowel ischemia, but the consequences of cardiac arrest on the human small bowel have been rarely studied. Plasma citrulline concentration is a marker of functional enterocyte mass, and plasma intestinal fatty acid-binding protein (I-FABP) concentration is a marker of enterocyte damage. We aimed to measure enterocyte biomarkers after cardiac arrest and to study the prognostic value of biomarker abnormalities. This is a prospective, observational, single-center study of patients admitted to the intensive care unit (ICU) for cardiac arrest, evaluating plasma citrulline and I-FABP concentrations at admission and after 24  h and variables according to the Utstein criteria. Variables according to 28-day Cerebral Performance Category score of 1 to 2 (good neurological outcome) versus 3 to 5 (poor neurological outcome) were compared. Sixty-nine patients with cardiac arrest of both cardiac and hypoxic origin were included. At ICU admission, plasma citrulline concentration was low in 65% and plasma I-FABP was elevated in 82% of the patients. After 24  h, plasma citrulline was low in 82% and I-FABP was normal in 60% of the patients. Patients with a poor neurological outcome had a lower plasma citrulline concentration and a higher I-FABP concentration at ICU admission. By multivariate analysis, plasma citrulline levels of 13.1  μmol L or less and I-FABP more than 260  pg mL were independently associated with a poor neurological outcome (odds ratio, 21.9 [2.2-215], and odds ratio, 13.6 [1.4-129], respectively). Cardiac arrest resuscitation is associated with evidence of small bowel mucosal damage in most patients, with a short and intense I-FABP elevation at admission and a decrease in citrulline concentration during the first day. In this study, low plasma citrulline and high I-FABP concentrations at ICU admission were predictive of a poor neurological outcome. This study confirms that cardiac arrest is a model of

  13. Indicators of Subarachnoid Hemorrhage as a Cause of Sudden Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Joseph Zachariah


    Full Text Available Subarachnoid hemorrhage (SAH may present with cardiac arrest (SAH-CA. We report a case of SAH-CA to assist providers in distinguishing SAH as an etiology of cardiac arrest despite electrocardiogram findings that may be suggestive of a cardiac etiology. SAH-CA is associated with high rates of return of spontaneous circulation, but overall poor outcome. An initially non-shockable cardiac rhythm and the absence of brain stem reflexes are important clues in indentifying SAH-CA.

  14. Systemic Inflammatory Response and Potential Prognostic Implications After Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Wanscher, Michael


    , interleukin-6 was independently associated with mortality, whereas both interleukin-6 levels (hazard ratio=1.23 [1.01-1.49]; p=0.04) and procalcitonin levels (hazard ratio=1.20 [1.03-1.39]; p=0.02) 24 hours after out-of-hospital cardiac arrest were associated with 30-day mortality with no interactions between.......63, respectively. CONCLUSIONS: Level of inflammation, assessed by interleukin-6 and procalcitonin, was independently associated with increased mortality with the highest discriminative value obtained 24 hours after out-of-hospital cardiac arrest. Interventions aiming at decreasing level of inflammation as a way...

  15. Sodium/hydrogen-exchanger inhibition during cardioplegic arrest and cardiopulmonary bypass: an experimental study. (United States)

    Cox, Charles S; Sauer, Henning; Allen, Steven J; Buja, L Maximilian; Laine, Glen A


    We sought to determine whether pretreatment with a sodium/hydrogen-exchange inhibitor (EMD 96 785) improves myocardial performance and reduces myocardial edema after cardioplegic arrest and cardiopulmonary bypass. Anesthetized dogs (n = 13) were instrumented with vascular catheters, myocardial ultrasonic crystals, and left ventricular micromanometers to measure preload recruitable stroke work, maximum rate of pressure rise (positive and negative), and left ventricular end-diastolic volume and pressure. Cardiac output was measured by means of thermodilution. Myocardial tissue water content was determined from sequential biopsy. After baseline measurements, hypothermic (28 degrees C) cardiopulmonary bypass was initiated. Cardioplegic arrest (4 degrees C Bretschneider crystalloid cardioplegic solution) was maintained for 2 hours, followed by reperfusion-rewarming and separation from cardiopulmonary bypass. Preload recruitable stroke work and myocardial tissue water content were measured at 30, 60, and 120 minutes after bypass. EMD 96 785 (3 mg/kg) was given 15 minutes before bypass, and 2 micromol was given in the cardioplegic solution. Control animals received the same volume of saline vehicle. Arterial-coronary sinus lactate difference was similar in both animals receiving EMD 96 785 and control animals, suggesting equivalent myocardial ischemia in each group. Myocardial tissue water content increased from baseline in both animals receiving EMD 96 785 and control animals with cardiopulmonary bypass and cardioplegic arrest but was statistically lower in animals receiving EMD 96 785 compared with control animals (range, 1.0%-1.5% lower in animals receiving EMD 96 785). Preload recruitable stroke work decreased from baseline (97 +/- 2 mm Hg) at 30 (59 +/- 6 mm Hg) and 60 (72 +/- 9 mm Hg) minutes after cardiopulmonary bypass and cardioplegic arrest in control animals; preload recruitable stroke work did not decrease from baseline (98 +/- 2 mm Hg) in animals receiving

  16. Optimizing survival outcomes for adult patients with nontraumatic cardiac arrest [digest]. (United States)

    Jung, Julianna; Zaurova, Milana


    Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm. Management of cardiac arrest in circumstances such as pregnancy, pulmonary embolism, opioid overdose and other toxicologic causes, hypothermia, and coronary ischemia are also reviewed. [Points & Pearls is a digest of Emergency Medicine Practice].

  17. Technology-facilitated Organized Abuse: An Examination of Law Enforcement Arrest Cases

    Directory of Open Access Journals (Sweden)

    Janis Wolak


    Full Text Available This paper looks at cases of organized abuse (that is, two or more offenders working in concert and having two or more victims, not solely familial reported by law enforcement respondents during the three waves of the National Juvenile Online Victimization (NJOV Study (n=29. The NJOV Study collected data from a national US sample of law enforcement agencies about technology-facilitated crimes ending in arrest at three time points: mid-2000 to mid-2001, 2005 and 2009. The paper reports on the prevalence of technology-facilitated organized abuse ending in arrest, contexts of cases and characteristics of offenders and victims. 

  18. Intracellular pH in Gastric and Rectal Tissue Post Cardiac Arrest (United States)

    Fisher, Elaine M.; Steiner, Richard P.; LaManna, Joseph C.

    We directly measured pHi using the pH sensitive dye, neutral red. We defined pHi for rectal and gastric tissue in whole tissue and by layer under control and arrest conditions. Fifteen minutes of arrest was not sufficient time to alter the pHi at the rectal or gastric site. On initial inspection, the stomach may be more sensitive to ischemic changes than the rectum. Understanding the mechanism by which PCO2 generation is used to track clinical changes is vital to the early detection of tissue dysoxia in order to effectively treat and manage critically ill patients.

  19. The Ethical and Legal Implications of a Nurse's Arrest in Utah. (United States)

    Olsen, Douglas P; Brous, Edie


    Editor's note: On July 26, 2017, Alex Wubbels, the charge nurse on the burn unit at the University of Utah Hospital in Salt Lake City, was arrested for refusing to allow a police officer to draw blood from an unconscious patient in her care. Her arrest, during which she was forcefully placed in handcuffs and dragged out of the hospital, was documented on body camera video and drew national attention. We asked our ethical and legal contributing editors to provide some insight on the issues of this case.

  20. Gender differences in 24-hour outcome following resuscitation after 9 minutes of cardiac arrest in dogs. (United States)

    Zwemer, C F; O'Connor, E M; Whitesall, S E; D'Alecy, L G


    To examine possible gender-specific differences in 24-hr outcome following resuscitation from 9 mins of controlled cardiac arrest. Preclinical, prospective study comparing two similarly prepared, independent control groups (one female group, one male group) included in a larger series of studies. Physiology research laboratory at a major medical center. Male and female mongrel dogs (Canis familiaris), weighing 16 to 22 kg. Cardiopulmonary-cerebral resuscitation following 9 mins of normothermic cardiac arrest in male vs. female dogs. Mean arterial blood pressure, heart rate, urine output, arterial blood oxygen, and PCO2 values, arterial pH, temperature, plasma glucose concentrations, and hematocrit were measured and recorded at the precardiac arrest and postcardiac arrest period, and at 30 mins, and 1, 4, 6, 12, and 24 hrs following resuscitation. Neurologic dysfunction was assessed using a well-standardized neurologic deficit score assigned at 6, 12, and 24 hrs after arrest. Plasma concentrations of malonaldehyde, 4-hydroxynonenal, and erythrocyte-reduced glutathione were measured at the precardiac arrest period, and 6, 12, and 24 hrs following resuscitation. Additionally, serum concentrations of alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase, gamma-glutamyl transferase, creatinine kinase, creatinine, albumin, and total protein were measured before arrest, and at 6, 12, and 24 hrs after resuscitation. Plasma concentrations of inorganic phosphorus, blood urea nitrogen, and electrolytes (sodium, chloride, calcium, and potassium) were measured. The estrous cycle phase in the female dogs enrolled in the study was determined by physical examination and vaginal cytology. No prearrest differences were detectable between males and females in basic physiologic variables. No differences in neurologic deficit were detectable between males and females across the 24-hr recovery period following resuscitation. No detectable

  1. Management of severe hypercapnia post cardiac arrest with extracorporeal carbon dioxide removal. (United States)

    Tiruvoipati, R; Gupta, S; Haji, K; Braun, G; Carney, I; Botha, J A


    Normocapnia is recommended in intensive care management of patients after out-of-hospital cardiac arrest. While normocapnia is usually achievable, it may be therapeutically challenging, particularly in patients with airflow obstruction. Conventional mechanical ventilation may not be adequate to provide optimal ventilation in such patients. One of the recent advances in critical care management of hypercapnia is the advent of newer, low-flow extracorporeal carbon dioxide clearance devices. These are simpler and less invasive than conventional extracorporeal devices. We report the first case of using a novel, extracorporeal carbon dioxide removal device in Australia on a patient with out-of-hospital cardiac arrest where mechanical ventilation failed to achieve normocapnia.

  2. Youth, Underemployment, and Property Crime: Differential Effects of Job Availability and Job Quality on Juvenile and Young Adult Arrest Rates. (United States)

    Allan, Emilie Andersen; Steffensmeier, Darrell J.


    Examination of age-specific state-level data from the 1977-1980 reports of the Federal Bureau of Investigation and the Census Bureau reveals that availability of employment produces strong effects on juvenile arrest rates. Unemployment and low quality of employment (e.g., inadequate pay and hours) is associated with high arrest rates. (Author/BJV)

  3. In-hospital cardiac arrest is associated with use of non-antiarrhythmic QTc-prolonging drugs

    NARCIS (Netherlands)

    de Bruin, Marie L.; Langendijk, Pim N. J.; Koopmans, Richard P.; Wilde, Arthur A. M.; Leufkens, Hubert G. M.; Hoes, Arno W.


    AIMS: QTc interval-prolonging drugs have been linked to cardiac arrhythmias, cardiac arrest and sudden death. In this study we aimed to quantify the risk of cardiac arrest associated with the use of non-antiarrhythmic QTc-prolonging drugs in an academic hospital setting. METHODS: We performed a

  4. Genetic mutation in Korean patients of sudden cardiac arrest as a surrogating marker of idiopathic ventricular arrhythmia. (United States)

    Son, Myoung Kyun; Ki, Chang-Seok; Park, Seung-Jung; Huh, June; Kim, June Soo; On, Young Keun


    Mutation or common intronic variants in cardiac ion channel genes have been suggested to be associated with sudden cardiac death caused by idiopathic ventricular tachyarrhythmia. This study aimed to find mutations in cardiac ion channel genes of Korean sudden cardiac arrest patients with structurally normal heart and to verify association between common genetic variation in cardiac ion channel and sudden cardiac arrest by idiopathic ventricular tachyarrhythmia in Koreans. Study participants were Korean survivors of sudden cardiac arrest caused by idiopathic ventricular tachycardia or fibrillation. All coding exons of the SCN5A, KCNQ1, and KCNH2 genes were analyzed by Sanger sequencing. Fifteen survivors of sudden cardiac arrest were included. Three male patients had mutations in SCN5A gene and none in KCNQ1 and KCNH2 genes. Intronic variant (rs2283222) in KCNQ1 gene showed significant association with sudden cardiac arrest (OR 4.05). Four male sudden cardiac arrest survivors had intronic variant (rs11720524) in SCN5A gene. None of female survivors of sudden cardiac arrest had SCN5A gene mutations despite similar frequencies of intronic variants between males and females in 55 normal controls. Common intronic variant in KCNQ1 gene is associated with sudden cardiac arrest caused by idiopathic ventricular tachyarrhythmia in Koreans.

  5. Prevention of deterioration of ventricular fibrillation by basic life support during out-of-hospital cardiac arrest

    NARCIS (Netherlands)

    Waalewijn, Reinier A.; Nijpels, Marië A.; Tijssen, Jan G.; Koster, Rudolph W.


    Survival of cardiac arrest is improved by basic life support (BLS). This study investigated the relationship between ventricular fibrillation (VF) characteristics and survival. In a 2-year prospective study out-of-hospital witnessed non-traumatic cardiac arrests were observed. The probabilities of

  6. Comparison of different test methods to assess thermal stresses of metal oxide surge arresters under pollution conditions

    International Nuclear Information System (INIS)

    Bargigia, A.; de Nigris, M.; Pigini, A.; Sironi, A.


    The report deals with the research conducted by ENEL, the Italian Electricity Board, to assess the performance of zinc oxide surge arresters under pollution condition, with special reference to the consequent thermal stress on internal active parts which can affect the energy handling capabality of the arrester and may lead, in particular conditions, even to thermal runaway

  7. Epinephrine in cardiac arrest: systematic review and meta-analysis. (United States)

    Morales-Cané, Ignacio; Valverde-León, María Del Rocío; Rodríguez-Borrego, María Aurora


    evaluate the effectiveness of epinephrine used during cardiac arrest and its effect on the survival rates and neurological condition. systematic review of scientific literature with meta-analysis, using a random effects model. The following databases were used to research clinical trials and observational studies: Medline, Embase and Cochrane, from 2005 to 2015. when the Return of Spontaneous Circulation (ROSC) with administration of epinephrine was compared with ROSC without administration, increased rates were found with administration (OR 2.02. 95% CI 1.49 to 2.75; I2 = 95%). Meta-analysis showed an increase in survival to discharge or 30 days after administration of epinephrine (OR 1.23; 95% IC 1.05-1.44; I2=83%). Stratification by shockable and non-shockable rhythms showed an increase in survival for non-shockable rhythm (OR 1.52; 95% IC 1.29-1.78; I2=42%). When compared with delayed administration, the administration of epinephrine within 10 minutes showed an increased survival rate (OR 2.03; 95% IC 1.77-2.32; I2=0%). administration of epinephrine appears to increase the rate of ROSC, but when compared with other therapies, no positive effect was found on survival rates of patients with favorable neurological status. avaliar a efetividade da adrenalina na parada cardíaca e seu efeito na sobrevivência e no estado neurológico. revisão sistemática da literatura científica com meta-análise utilizando um modelo de efeitos aleatórios. Revisão em Medline, Embase e Cochrane, desde 2005 até 2015 de ensaios clínicos e estudos observacionais. observou-se aumento nas taxas de retorno de circulação espontânea com a administração de adrenalina (OR 2,02; 95% IC 1,49-2,75; I2=95%) comparadas com a não administração de adrenalina. A meta-análise mostrou um aumento da sobrevivência na alta ou depois de 30 dias da administração de adrenalina (OR 1,23; 95% IC 1,05-1,44; I2=83%). Quando estratificados por ritmos desfibrilháveis e não desfibrilh

  8. Clinical evaluation of unselected cardiac arrest survivors in a tertiary center over a 1-year period (the LAZARUZ study)

    DEFF Research Database (Denmark)

    Marstrand, Peter; Corell, Pernille; Henriksen, Finn Lund


    OBJECTIVES: When the cause of an aborted cardiac arrest is unclear the initiation of therapy, counseling and family screening is challenging. METHODS: We included 43 unselected, prospectively identified cardiac arrest survivors with or without a diagnosis. Family history for cardiac disease...... and supplemental electrocardiograms were evaluated for additional diagnostic information. RESULTS: 43 cardiac arrest survivors were included, 34 (79%) were male and the average age was 48years (range 23-64, SD 13.0). The most common etiologies identified in cardiac arrest survivors were ischemic heart disease (33......%), cardiomyopathies (14%), miscellaneous (e.g. drug induced arrhythmias, coronary spasms) (12%) and channelopathies (5%). Family history of cardiac disease - even inheritable conditions - was not indicative of etiology in cardiac arrest survivors. Supplemental ECGs were abnormal in 10 of 43 patients; in the majority...

  9. Does Police Intervention in Intimate Partner Violence Work? Estimating the Impact of Batterer Arrest in Reducing Revictimization

    Directory of Open Access Journals (Sweden)

    Hyunkag Cho


    Full Text Available A variety of societal interventions in intimate partner violence have been established for decades, including the police actively arresting perpetrators. However, it is difficult to find consistent study results to show if arrest is effective. Moreover, there are far fewer studies on victims than on perpetrators. This study utilized the National Crime Victimization Survey to examine if victims whose partners were arrested were less revictimized than those whose partners were not arrested. Results clearly showed that arrest of perpetrators was effective in reducing revictimization, controlling for victims’ characteristics and the nature of violence incidents. Also, separated or divorced women showed the highest risk of revictimization. Comparisons with previous studies and implications on police policies are discussed.

  10. Recidivism, Costs, and Psychosocial Outcomes for a Post-Arrest Juvenile Diversion Program (United States)

    Hodges, Kay; Martin, Lisa A.; Smith, Cynthia; Cooper, Shaun


    Recidivism, costs, and psychosocial outcomes are reported for a post-arrest diversion program in Wayne County (Detroit), MI. Program features included: rapid, standardized assessment of psychosocial functioning with the Juvenile Inventory For Functioning[R], an individualized plan for addressing needs, engagement of caregivers, service provision…

  11. The School Nurse Role in Preparing for Sudden Cardiac Arrest in the School Setting (United States)

    Evans, Warna K.; Ficca, Michelle


    Automated external defibrillators (AEDs) were introduced for first responders in 1992 to manage adult cardiac arrest and are now common in many public places. Today AEDs are capable of shocking children under 8 years of age, or less than 55 pounds. This presents a challenge for school nurses, particularly as the prevalence of chronic medical…

  12. Willingness to Perform Chest Compression Only in Witnessed Cardiac Arrest Victims versus Cardiopulmonary Resuscitation in Iran

    Directory of Open Access Journals (Sweden)

    Nesreen Yaghmour


    Full Text Available Background: Performing immediate bystander Cardio Pulmonary Resuscitation (CPR is the most important factor that determines survival from cardiac arrest. Recommended mouth to mouth ventilation maneuver during CPR has led to lower rate of CPR performance in the population. Objectives: The present survey aimed to evaluate the willingness of nurses at Shiraz University of Medical Sciences for performing CPR versus chest-compression-only CPR. Patients and Methods: During a CPR course, we performed a survey on 25 nurses from Shiraz University of Medical Sciences, Iran. This survey included age and gender of the participants. In the first question, they were asked about their willingness to perform CPR with mouth to mouth breathing for witnessed cardiac arrest victims. In the second question, they were asked about their willingness to perform chest compression only for cardiac arrest victims. Results: Among the participating nurses, 96% were female with a mean age of 31 years. Only 40% were willing to perform CPR that requires mouth to mouth ventilation. On the other hand, 92% were willing to perform chest compression only without mouth to mouth ventilation. The mean age of the nurses who would do CPR was lower compared to those who would not. Conclusions: In this survey, we demonstrated that eliminating mouth to mouth ventilation maneuver could lead to markedly higher willingness to perform CPR for witnessed cardiac arrest victims in CPR trained nursing personnel. Our study is in agreement with other studies advocating that chest-compression-only CPR could lead to higher bystander resuscitation efforts.

  13. Withholding or termination of resuscitation in pediatric out-of-hospital traumatic cardiopulmonary arrest. (United States)

    Fallat, Mary E


    This multiorganizational literature review was undertaken to provide an evidence base for determining whether recommendations for out-of-hospital termination of resuscitation could be made for children who are victims of traumatic cardiopulmonary arrest. Although there is increasing acceptance of out-of-hospital termination of resuscitation for adult traumatic cardiopulmonary arrest when there is no expectation of a good outcome, children are routinely excluded from state termination-of-resuscitation protocols. The decision to withhold resuscitative efforts in a child under specific circumstances (decapitation or dependent lividity, rigor mortis, etc) is reasonable. If there is any doubt as to the circumstances or timing of the traumatic cardiopulmonary arrest, under the current status of limiting termination of resuscitation in the field to persons older than 18 years in most states, resuscitation should be initiated and continued until arrival to the appropriate facility. If the patient has arrested, resuscitation has already exceeded 30 minutes, and the nearest facility is more than 30 minutes away, involvement of parents and family of these children in the decision-making process with assistance and guidance from medical professionals should be considered as part of an emphasis on family-centered care because the evidence suggests that either death or a poor outcome is inevitable.

  14. EMuRgency: Addressing cardiac arrest with socio-technical innovation in a smart learning region

    NARCIS (Netherlands)

    Kalz, Marco; Klerkx, Joris; Parra, Gonzalo; Haberstroh, Max; Elsner, Jesko; Ternier, Stefaan; Schilberg, Daniel; Jeschke, Sabina; Duval, Erik; Specht, Marcus


    Kalz, M., Klerx, J., Parra, G., Haberstroh, M., Elsner, J., Ternier, S., Schilberg, D., Jeschke, S., Duval, E., & Specht, M. (2013). EMuRgency: Addressing cardiac arrest with socio-technical innovation in a smart learning region. Interaction Design and Architectures Journal. Summer 2013 (17), 77-91.

  15. Deslorelin for the treatment of hair cycle arrest in intact male dogs. (United States)

    Albanese, Francesco; Malerba, Eleonora; Abramo, Francesca; Miragliotta, Vincenzo; Fracassi, Federico


    Hair cycle arrest (alopecia X) refers to a canine alopecic condition of unknown pathogenesis, characterized by symmetrical, nonpruritic and noninflammatory alopecia that spares the head and distal extremities. The objective of this study was prospectively to evaluate the efficacy of a 4.7 mg deslorelin implant in the treatment of intact male and neutered female dogs affected by hair cycle arrest. Ten Pomeranian dogs (eight intact males, two neutered females), four Italian spitz (three intact males, one neutered female), three miniature poodles (two intact males, one neutered female), two Siberian huskies (both intact males) and one intact male chow chow dog with confirmed hair cycle arrest were included in the study. Each dog was treated with a subcutaneous sterile implant containing 4.7 mg deslorelin. Responder dogs were re-implanted 6 months after the first implant in order to obtain a 1 year pharmacological exposure and 1 year of follow-up. Hair regrowth was visible within 3 months in 12 of 16 intact male dogs (75%); no hair regrowth was noted in any neutered female dogs. The overall response to therapy was 60%. No adverse effects were noted. These findings suggest that deslorelin may be a treatment option for intact male dogs with idiopathic hair cycle arrest. Deslorelin is an alternative to current therapies and castration. © 2014 ESVD and ACVD.

  16. Cytotoxic Activity and G1 Cell Cycle Arrest of a Dienynone from Echinacea pallida

    DEFF Research Database (Denmark)

    Chicca, Andrea; Adinolfi, Barbara; Pellati, Federica


    (Jurkat and HL-60), breast carcinoma (MCF-7), and melanoma (MeWo) cells. As part of its mechanism of action, the ability of this constituent to arrest the cell cycle in the G1 phase was demonstrated on HL-60 cells. Furthermore, a stability test of the target compound over 72 h was carried out, indicating...

  17. Gene expression signature in organized and growth arrested mammaryacini predicts good outcome in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fournier, Marcia V.; Martin, Katherine J.; Kenny, Paraic A.; Xhaja, Kris; Bosch, Irene; Yaswen, Paul; Bissell, Mina J.


    To understand how non-malignant human mammary epithelial cells (HMEC) transit from a disorganized proliferating to an organized growth arrested state, and to relate this process to the changes that occur in breast cancer, we studied gene expression changes in non-malignant HMEC grown in three-dimensional cultures, and in a previously published panel of microarray data for 295 breast cancer samples. We hypothesized that the gene expression pattern of organized and growth arrested mammary acini would share similarities with breast tumors with good prognoses. Using Affymetrix HG-U133A microarrays, we analyzed the expression of 22,283 gene transcripts in two HMEC cell lines, 184 (finite life span) and HMT3522 S1 (immortal non-malignant), on successive days post-seeding in a laminin-rich extracellular matrix assay. Both HMECs underwent growth arrest in G0/G1 and differentiated into polarized acini between days 5 and 7. We identified gene expression changes with the same temporal pattern in both lines. We show that genes that are significantly lower in the organized, growth arrested HMEC than in their proliferating counterparts can be used to classify breast cancer patients into poor and good prognosis groups with high accuracy. This study represents a novel unsupervised approach to identifying breast cancer markers that may be of use clinically.

  18. Platelet aggregation during targeted temperature management after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Jeppesen, Anni Nørgaard; Hvas, Anne-Mette; Grejs, Anders Morten


    temperature management affected platelet aggregation. We randomised 82 comatose patients resuscitated after out-of-hospital cardiac arrest to either 24 hours (standard group) or 48 hours (prolonged group) of targeted temperature management at 33±1°C. Blood samples were collected 22 hours, 46 hours and 70......® decreased by 14% (95% CI -8%;-20%), p management....

  19. Hospital discharge diagnoses of ventricular arrhythmias and cardiac arrest were useful for epidemiologic research

    DEFF Research Database (Denmark)

    De Bruin, M L; van Hemel, N M; Leufkens, H G M


    OBJECTIVE: We investigated the validity of hospital discharge diagnosis regarding ventricular arrhythmias and cardiac arrest. METHODS: We identified patients whose record in the PHARMO record linkage system database showed a code for ventricular or unspecified cardiac arrhythmias according to cod...... according to ICD-9-CM as paroxysmal ventricular tachycardia, ventricular fibrillation, ventricular flutter, ventricular premature beats, or cardiac arrest) have a high PPV and are useful for selecting events in epidemiological studies on drug-induced arrhythmias.......OBJECTIVE: We investigated the validity of hospital discharge diagnosis regarding ventricular arrhythmias and cardiac arrest. METHODS: We identified patients whose record in the PHARMO record linkage system database showed a code for ventricular or unspecified cardiac arrhythmias according to codes...... of the International Classification of Diseases, 9th revision, clinical modification (ICD-9-CM). The validity of ICD codes for ventricular arrhythmias and cardiac arrest (427.1, 427.4, 427.41, 427.42, 427.5, 427.69) and ICD codes for unspecified cardiac arrhythmias (427.2, 427.60, 427.8, 427.89, 427.9) was ascertained...

  20. Intravenous lipid emulsion in the resuscitation of cocaine-induced cardiovascular arrest in a rat model. (United States)

    Chai, Peter R; Hack, Jason B


    Intravenous lipid emulsion (ILE) is a potential antidote for severe overdose of certain lipophilic drugs. Cocaine overdose is often fatal and has no antidote. The use of ILE after cocaine-induced cardiac arrest has been suggested but is not well characterized. The objective of the study is to determine if ILE would reverse cocaine-induced cardiac arrest in a rat model. Twelve Sprague-Dawley rats with intra-arterial and intravenous access were sedated with isoflurane and split into 2 cocaine dose groups, then given either ILE or normal saline (NS) intravenously (IV)-group A, 7 animals received cocaine (10 mg/kg IV) with 6 of 7 given ILE (15 mg/kg IV) and 1 of 7 given NS (equal volume); group B, 5 animals received cocaine (5 mg/kg IV) with 3 of 5 given ILE (15 mg/kg IV) and 2 of 5 given NS (equal volume). Closed chest compressions were initiated for asystole and continued for 15 minutes with rhythm checks every minute. All 12 rats experienced cardiac arrest after cocaine bolus. Resuscitation was successful in 1 of 7 rats in group A and 0 of 5 in group B. Intravenous lipid emulsion administration did not affect outcome of cocaine-induced cardiac arrest compared with control in this model. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. [Analysis of care in cardiorespiratory arrest in an emergency medical unit]. (United States)

    Hormeño Bermejo, Rosa María; Cordero Torres, Juan Antonio; Garcés Ibáñez, Gloria; Escobar, Antonia Escobar; Santos García, Alberto Javier; Fernández de Aguilar, Jesús Arroyo


    To describe the epidemiological profile of cardiac arrests and to determine factors associated with successful cardiopulmonary resuscitation (CPR). Retrospective descriptive observational study. SITES: Badajoz city (Spain) and population attended by the Medical Emergency Unit of the Public Health System in that city. A study 359 cardiac arrests resuscitated between January 2002 and May 2009. Out of the cardiac arrests that ocurred in adults, 65.40% were male, the cause was not traumatic in 88%; 65.70% occurred in the patient's home,and in 6% of the cases there had been basic life support. The higher success rate after was achieved in adult male patients (OR: 0,43; CI 95%; 0.25-0.73; P=.002), whose rhythm was shockable (OR: 0,16; CI 95%: 0,09-0,27; Parrests are more common in adults and in few cases CPR is previously performed. Male gender, an initial shockable rhythm, and the early initiation of advanced life support, are associated with higher success of CPR. There were few CPR performed in cardiac arrest in children, and the prognosis was more unfavorable. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  2. ECMO as an effective rescue therapeutic for fulminant myocarditis complicated with refractory cardiac arrest

    Directory of Open Access Journals (Sweden)

    Li YT


    Full Text Available Ya-Ting Li,1,* Li-Fen Yang,1,* Zhuang-Gui Chen,1,* Li Pan,1 Meng-Qi Duan,1 Yan Hu,2 Cheng-bin Zhou,3 Yu-Xiong Guo2 1Pediatric Intensive Care Unit, Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 2Pediatric Intensive Care Unit, Department of Pediatrics, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 3Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China *These authors contributed equally to this work Abstract: Fulminant myocarditis (FM is a life-threatening disease in children. With a rapid, progressive course of deterioration, it causes refractory cardiorespiratory failure even with optimal clinical intervention. We present the case of a 9-year-old girl with FM complicated by cardiogenic shock, malignant arrhythmia, and refractory cardiac arrest. She received effective cardiopulmonary resuscitation, therapeutic hypothermia, and other supportive treatments. However, the patient rapidly worsened into pulseless ventricular tachycardia and refractory cardiac arrest. Therefore, we performed extracorporeal membrane oxygenation (ECMO to establish spontaneous circulation after the failure of standard resuscitation measures. The girl recovered with intact cardiac and neurocognitive functions after continued ECMO treatment for 221 hours. Therefore, ECMO is an effective rescue therapeutics for FM, especially when complicated with refractory cardiac arrest. Keywords: cardiac arrest, children, extracorporeal membrane oxygenation, fulminant myocarditis

  3. Cardiac arrest in an obstetric patient using remifentanil patient-controlled analgesia. (United States)

    Marr, R; Hyams, J; Bythell, V


    This case report describes the management of a patient, diagnosed with an intrauterine death at 31 weeks' gestation, who suffered a cardiorespiratory arrest during her induced labour while using a remifentanil PCA. She made a full recovery from resuscitation which included a peri-mortem caesarean section. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

  4. Cardiorespiratory interactions and blood flow generation during cardiac arrest and other states of low blood flow. (United States)

    Sigurdsson, Gardar; Yannopoulos, Demetris; McKnite, Scott H; Lurie, Keith G


    Recent advances in cardiopulmonary resuscitation have shed light on the importance of cardiorespiratory interactions during shock and cardiac arrest. This review focuses on recently published studies that evaluate factors that determine preload during chest compression, methods that can augment preload, and the detrimental effects of hyperventilation and interrupting chest compressions. Refilling of the ventricles, so-called ventricular preload, is diminished during cardiovascular collapse and resuscitation from cardiac arrest. In light of the potential detrimental effects and challenges of large-volume fluid resuscitations, other methods have increasing importance. During cardiac arrest, active decompression of the chest and impedance of inspiratory airflow during the recoil of the chest work by increasing negative intrathoracic pressure and, hence, increase refilling of the ventricles and increase cardiac preload, with improvement in survival. Conversely, increased frequency of ventilation has detrimental effects on coronary perfusion pressure and survival rates in cardiac arrest and severe shock. Prolonged interruption of chest compressions for delivering single-rescuer ventilation or analyzing rhythm before shock delivery is associated with decreased survival rate. Cardiorespiratory interactions are of profound importance in states of cardiovascular collapse in which increased negative intrathoracic pressure during decompression of the chest has a favorable effect and increased intrathoracic pressure with ventilation has a detrimental effect on survival rate.

  5. Study regarding the survival of patients suffering a traumatic cardiac arrest. (United States)

    Georgescu, V; Tudorache, O; Nicolau, M; Strambu, V


    Severe trauma is the most frequent cause of death in young people, in civilized countries with major social and vital costs. The speed of diagnostic decision making and the precocity of treatment approaches are both essential and depend on the specialists' colaboration. The present study aims to emphasize the actual situation of medical interventions in case of cardiorespiratory arrest due to trauma. 1387 patients who suffered a cardio respiratory arrest both traumatic and non-traumatic were included in order to point out the place of traumatic arrest. Resuscitation of such patients is considered useless and resource consumer by many trauma practitioners who are reporting survival rates of 0%-3.5%. As the determinant of lesions, trauma etiology was as it follows car accidents - 43%, high falls - 30%, suicidal attempts - 3%, domestic violence - 3%, other causes - 21%. Hypovolemia remains the major cause of cardiac arrest and death and that is why the efforts of emergency providers (trauma team) must be oriented towards "hidden death" in order to avoid it. This condition could be revealed and solved easier with minimal diagnostic and therapeutic maneuvers in the emergency department.

  6. Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest

    DEFF Research Database (Denmark)

    Nielsen, Niklas; Wetterslev, Jørn; Cronberg, Tobias


    Background Unconscious survivors of out-of-hospital cardiac arrest have a high risk of death or poor neurologic function. Therapeutic hypothermia is recommended by international guidelines, but the supporting evidence is limited, and the target temperature associated with the best outcome is unkn...

  7. Sudden Cardiac arrest Risk profile in a group of amateur level ...

    African Journals Online (AJOL)

    ... males and females in this group of university basketball players showed varying signs of SCA risk, with the overall risk being reasonably low, albeit abnormalities were highlighted in some and Marfanoid characteristics were clearly evident in others. Key words: Sudden cardiac arrest; Basketball players, Marfan syndrome; ...

  8. Identifying non-technical skills and barriers for improvement of teamwork in cardiac arrest teams

    DEFF Research Database (Denmark)

    Andersen, P.O.; Jensen, Michael Kammer; Lippert, A.


    2006 to November 2006. Interviews were focussed on barriers and recommendations for teamwork in the cardiac arrest team, optimal policy for improvement of resuscitation training and clinical practice, use of cognitive aids and adoption of European Resuscitation Council (ERC) Guidelines 2005. Interviews...

  9. Effects of anxiety on the execution of police arrest and self-defense skills

    NARCIS (Netherlands)

    Renden, P.G.; Landman, H.M.; Geerts, S.F.; Jansen, S.E.M.; Faber, G.S.; Savelsbergh, G.J.P.; Oudejans, R.R.D.


    We investigated the effects of anxiety on the execution of police officers' arrest and self-defense skills. Police officers (n=13) performed three tasks in which they kicked, blocked, or restrained an opponent who attacked them with a rubber knife (low anxiety, LA) or a shock knife (high anxiety,

  10. Increased prevalence of ECG markers for sudden cardiac arrest in refractory epilepsy

    NARCIS (Netherlands)

    Lamberts, R. J.; Blom, M. T.; Novy, J.; Belluzzo, M.; Seldenrijk, A.; Penninx, B. W.; Sander, J. W.; Tan, H. L.; Thijs, R. D.


    People with epilepsy are at increased risk of sudden cardiac arrest (SCA) due to ECG-confirmed ventricular tachycardia/fibrillation, as seen in a community-based study. We aimed to determine whether ECG-risk markers of SCA are more prevalent in people with epilepsy. In a cross-sectional,

  11. Increased prevalence of ECG markers for sudden cardiac arrest in refractory epilepsy

    NARCIS (Netherlands)

    Lamberts, R.; Blom, M.; Novy, J.; Belluzzo, M.; Seldenrijk, A.; Penninx, B.W.J.H.; Sander, J.; Tan, H.L.; Thijs, R.


    Background and aim: People with epilepsy are at increased risk of sudden cardiac arrest (SCA) due to ECG-confirmed ventricular tachycardia/fibrillation, as seen in a community-based study. We aimed to determine whether ECG-risk markers of SCA are more prevalent in people with epilepsy. Methods: In a

  12. Long-term prognosis after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Horsted, Tina I; Rasmussen, Lars S; Meyhoff, Christian S


    OBJECTIVE: In this study we aimed to report survival beyond 6 months, including quality of life, for patients after out-of-hospital cardiac arrest (OHCA) with a physician-based EMS in an urban area. METHODS: We collected data related to OHCA prospectively during a 2-year period. Long-term survival...

  13. Role of crack arrest in the evaluation of PWR pressure vessel integrity during PTS transients

    International Nuclear Information System (INIS)

    Cheverton, R.D.; Ball, D.G.


    The HSST program is investigating flaw behavior in large cylinders and is also obtaining fracture-mechanics-related material properties, while the Integrated Pressurized Thermal-Shock (IPTS) program is primarily concerned with an estimation of the overall frequency of vessel failure and identification of dominant transients and design and operating features contributing thereto for specific nuclear plants. One important component of the IPTS study is a probabilistic fracture-mechanics analysis of the reactor vessel, and a point of particular interest therein is the role of crack arrest in mitigating the consequences of the postulated PTS transients. The HSST program has provided crack-arrest data from small specimens and large thermal- and pressure-loaded cylinders that tend to establish the validity of the crack-arrest concept for application to the PTS problem. Unfortunately, recent results of the IPTS studies indicate that the inclusion of crack arrest in the probabilistic fracture-mechanics model does not substantially influence the calculated frequency of vessel failure. However, there are still significant questions regarding flaw behavior at upper-shelf temperatures, and the HSST program is continuing to pursue this area of uncertainty

  14. extracorporeal cardiopulmonary resuscitation for patients with out-of-hospital refractory cardiac arrest

    DEFF Research Database (Denmark)

    Obling, Laust; Wiberg, Sebastian; Møller, Jacob Eifer


    Out-of-hospital cardiac arrest is associated with high mortality and morbidity. Treatment options remain few in refractory cases, but extracorporeal cardiopulmonary resuscitation (eCPR) is increasingly applied to improve the outcome. This article summarizes the use, experience and outcome of e...

  15. GLP-1 analogues for neuroprotection after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Wiberg, Sebastian; Hassager, Christian; Thomsen, Jakob Hartvig


    Background: Attenuating the neurological damage occurring after out-of-hospital cardiac arrest is an ongoing research effort. This dual-centre study investigates the neuroprotective effects of the glucagon-like-peptide-1 analogue Exenatide administered within 4 hours from the return of spontaneous...

  16. Long-term neuropsychological outcomes in children and adolescents after cardiac arrest

    NARCIS (Netherlands)

    L. van Zellem (Lennart); C.M.P. Buysse (Corinne); M.J. Madderom (Marlous); F.K. Aarsen (Femke); J.S. Legerstee (Jeroen); D. Tibboel (Dick); E.M.W.J. Utens (Elisabeth)


    textabstractPurpose: Research into neuropsychological functioning of survivors of cardiac arrest (CA) in childhood is scarce. We sought to assess long-term neuropsychological functioning in children and adolescents surviving CA. Methods: Neuropsychological follow-up study involving all consecutive

  17. Change of cell cycle arrest of tumor cell lines after 60Co γ-irradiation

    International Nuclear Information System (INIS)

    Tang Yi; Liu Wenli; Zhou Jianfeng; Gao Qinglei; Wu Jianhong


    Objective: To observe the cell cycle arrest changes in peripheral blood mononuclear cells (PBMNCs) of normal persons and several kinds of tumor cell lines after 60 Co γ-irradiation. Methods: PBMNCs of normal persons, HL-60, K562, SiHA and 113 tumor cell lines were irradiated with 60 Co γ-rays at the absorbed doses of 6, 10,15 Gy. Cell cycles changes were checked 6, 12, 24, 48 and 60 h after the irradiation. Results: A stasis state was observed in normal person PBMNCs, 95 percents of which were in G 1 phase, and they still remained stasis after the irradiation. Except the 113 cell line manifesting G 1 phase arrest, all other tumor cell lines showed G 2 /M phase arrest after irradiation. The radiation sensitivity of HL-60 was higher than that of SiHA cell line. Conclusion: Different cell lines have different cell cycle arrest reaction to radiation and their radiation sensitivity are also different

  18. Insulin alone can lead to a withdrawal of meiotic arrest in the carp

    Indian Academy of Sciences (India)

    Meiotic arrest of oocyte in an Indian carp, Labeo rohita Ham. has been found for the first time to be withdrawn by insulin only. Addition of insulin to oocytes in vitro caused germinal vesicle breakdown (GVBD), one of the first visual markers to determine initiation of the final maturational process. Under the influence of insulin ...

  19. Evaluation of intensified prehospital treatment in out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Frandsen, F; Nielsen, J R; Gram, L


    of a test for dementia was assessed in long-term survivors (n = 30) together with 28 patients surviving acute myocardial infarction and 11 control persons. The results of the investigation demonstrate that the more intensive the prehospital treatment of out-of-hospital cardiac arrest, the more patients...

  20. Cardiac Arrest During Medically-Supervised Exercise Training: A Report of Fifteen Successful Defibrillations. (United States)

    Pyfer, Howard R.; And Others

    The Cardio-Pulmonary Research Institute conducted an exercise program for men with a history of coronary heart disease. Over 7 years, there were 15 cases of cardiac arrest during exercise (one for every 6,000 man-hours of exercise). Trained medical personnel were present in all cases, and all were resuscitated by electrical defibrillation with no…

  1. Influence of novobiocin on mitotic events and radiation-induced G2-arrest

    International Nuclear Information System (INIS)

    Rowley, R.


    Novobiocin was used in CHO cells to test for an involvement of topoisomerase II activity in; 1) the induction of, and recovery from, radiation-induced G 2 -arrest and 2) progression through mitosis. Novobiocin blocked recovery from G 2 -arrest with a concentration dependency which suggested that this effect resulted from protein synthesis inhibition. Novobiocin alone, at concentrations above 500 μgml, blocked cell progression in early mitosis. The transition point was distinct from that of protein and RNA synthesis inhibitors and was the only arrest point in mitosis. A similar block was imposed by coumermycin. While this may indicate a requirement for topoisomerase II activity during chromosome condensation, it was also associated with inhibition of histone phosphorylation. Histone H3 phosphorylation is believed to be necessary for chromosome condensation and, when inhibited by novobiocin, correlates with a block in premature chromatin condensation in tsBN2 cells. The authors' data thus unite these two findings, provide an opportunity to analyse the temporal relationship between histone phosphorylation and mitotic events and suggest that topological reorganization of the chromatin is not involved in radiation-induced G 2 arrest

  2. Gender Differences in Drug Use, Sexually Transmitted Diseases, and Risky Sexual Behavior among Arrested Youths* (United States)

    Dembo, Richard; Belenko, Steven; Childs, Kristina; Greenbaum, Paul E.; Wareham, Jennifer


    Data were collected on arrested youths processed at a centralized intake facility, including youths released back to the community and those placed in secure detention. This paper reports the results of a test of a structural model involving newly arrested male and female youths’ sexually transmitted diseases (STD) test results, urine analysis results for recent cocaine and marijuana use, and self-reported engaging in risky sexual behavior. The across gender, multiple group model involved: (1) a confirmatory factor analysis of these variables, reflecting a latent variable labeled Risk, (2) a regression of Risk on the youths’ age, and (3) an examination of the covariance between Risk and the youths’ race and seriousness of arrest charge. Results indicate the youths’ STD status, drug use, and reported risky sexual behavior are interrelated phenomena, similarly experienced across gender. Age was the only correlate of Risk status that demonstrated a significant gender group difference. The youths’ race and seriousness of arrest charges did not significantly affect Risk, regardless of gender. Research and policy implications of the findings are discussed. PMID:21221415

  3. Surgical thromboendarterectomy for chronic thromboembolic pulmonary hypertension using circulatory arrest with selective antegrade cerebral perfusion

    NARCIS (Netherlands)

    Zeebregts, CJAM; Dossche, KM; Morshuis, WJ; Knaepen, PJ; Schepens, MAAM

    The use of circulatory arrest with selective antegrade cerebral perfusion is described in a 59-year-old man who underwent thrombendarterectomy for chronic thromboembolic pulmonary hypertension. The postoperative course was uneventful. The described surgical technique may prevent the patient from

  4. Defibrillation probability and impedance change between shocks during resuscitation from out-of-hospital cardiac arrest

    NARCIS (Netherlands)

    Walker, Robert G.; Koster, Rudolph W.; Sun, Charles; Moffat, George; Barger, Joseph; Dodson, Pamela P.; Chapman, Fred W.


    Objective: Technical data now gathered by automated external defibrillators (AEDs) allows closer evaluation of the behavior of defibrillation shocks administered during out-of-hospital cardiac arrest. We analyzed technical data from a large case series to evaluate the change in transthoracic

  5. Illegal drugs in Grenada: arrests and drug treatment from 2001-2009. (United States)

    Fagorala, A


    Illegal drug use and abuse has increased in the Caribbean since the 1990s. In Grenada, statistical indicators such as admission rates to treatment facilities and drug arrests have provided evidence for the increased rates of illegal drug use and abuse. This study reviewed these statistical indicators and explored drug treatment options in Grenada from 2001 to 2009. A search of statistical records from the Drug Control Secretariat and the Grenada Drug Information Network/National Observatory on Drugs (GRENDIN/NOD) was performed. Literature review of relevant articles from search engines was used to support findings. Additionally, semi-structured interviews of key stakeholders from government and health agencies involved in drug prevention in Grenada were conducted to obtain information on recent developments surrounding drug arrests and treatments in Grenada. From 2001 to 2009, there were a 118% and a 23% increase in the arrest rate for males and females,respectively. There was also an increase in demand for drug treatment at the sole drug treatment facility. Preventive measures in schools and several forms of media programmes have raised awareness. However,drug use/abuse/activities still persist at a significant rate. Programmes that target improvement of treatment facilities and increased inter-agency collaboration may be successful in enhancing drug arrests and treatments.

  6. Total triterpenoids from Ganoderma Lucidum suppresses prostate cancer cell growth by inducing growth arrest and apoptosis. (United States)

    Wang, Tao; Xie, Zi-ping; Huang, Zhan-sen; Li, Hao; Wei, An-yang; Di, Jin-ming; Xiao, Heng-jun; Zhang, Zhi-gang; Cai, Liu-hong; Tao, Xin; Qi, Tao; Chen, Di-ling; Chen, Jun


    In this study, one immortalized human normal prostatic epithelial cell line (BPH) and four human prostate cancer cell lines (LNCaP, 22Rv1, PC-3, and DU-145) were treated with Ganoderma Lucidum triterpenoids (GLT) at different doses and for different time periods. Cell viability, apoptosis, and cell cycle were analyzed using flow cytometry and chemical assays. Gene expression and binding to DNA were assessed using real-time PCR and Western blotting. It was found that GLT dose-dependently inhibited prostate cancer cell growth through induction of apoptosis and cell cycle arrest at G1 phase. GLT-induced apoptosis was due to activation of Caspases-9 and -3 and turning on the downstream apoptotic events. GLT-induced cell cycle arrest (mainly G1 arrest) was due to up-regulation of p21 expression at the early time and down-regulation of cyclin-dependent kinase 4 (CDK4) and E2F1 expression at the late time. These findings demonstrate that GLT suppresses prostate cancer cell growth by inducing growth arrest and apoptosis, which might suggest that GLT or Ganoderma Lucidum could be used as a potential therapeutic drug for prostate cancer.

  7. Induction of cell cycle arrest and apoptosis by Ormenis eriolepis a ...

    African Journals Online (AJOL)

    Induction of cell cycle arrest and apoptosis by Ormenis eriolepis a Morrocan endemic plant in various human cancer cell lines. Lamiae Belayachi, Clara Aceves-Luquero, Nawel Merghoub, Silvia Fernández de Mattos, Saaïd Amzazi, Priam Villalonga, Youssef Bakri ...

  8. Insulin alone can lead to a withdrawal of meiotic arrest in the carp ...

    Indian Academy of Sciences (India)


    Meiotic arrest of oocyte in an Indian carp, Labeo rohita Ham. has been found for the first time to be withdrawn by insulin only. Addition of insulin to oocytes in vitro caused germinal vesicle breakdown (GVBD), one of the first visual markers to determine initiation of the final maturational process. Under the influence of insulin ...

  9. Cardiac arrest from intravenous indigo carmine during laparoscopic surgery -A case report- (United States)

    Lee, Won-Jae


    Indigo carmine (sodium indigotindisulfonate) is a safe, biologically inactive blue dye routinely administered intravascularly during urologic and gynecologic procedures to localize the ureteral orifices and to identify severed ureters and fistulous communications. We report a case of hypotension, cardiac arrest, and cerebral ischemia after the administration of indigo carmine in a patient under total laparoscopic hysterectomy. PMID:22323961

  10. Cloning and expression analysis of zygote arrest 1 (Zar1) in New ...

    Indian Academy of Sciences (India)


    Abstract. Zygote arrest 1 (Zar1) is an oocyte-specific maternal-effect gene. Previous studies indicate that Zar1 plays important role in early embryo development, but little is known about its function in rabbit. The objectives of this study were to clone the New. Zealand white rabbit Zar1 gene and to investigate its expression in ...

  11. Serious Mental Illness and Arrest: The Generalized Mediating Effect of Substance Use (United States)

    Swartz, James A.; Lurigio, Arthur J.


    Past studies of the mediating effects of substance use on the criminal justice involvement of the mentally ill have tended to focus on a single disorder, schizophrenia, and on violent crimes. This study examined the generality of the relationships among psychiatric disorders, substance use, and arrests for violent, nonviolent, and drug-related…

  12. Cardiac arrest during treatment of Pneumocystis carinii pneumonia with intravenous pentamidine isethionate

    DEFF Research Database (Denmark)

    Balslev, U; Berild, D; Nielsen, T L


    A 27-year-old man, HIV-positive for 4 years, developed ventricular fibrillation and cardiac arrest during treatment of Pneumocystis carinii pneumonia with intravenous pentamidine isethionate. The dosage was 4 mg/kg/day for 18 days. Nephrotoxicity occurred and raised serum potassium. The plasma...

  13. Arrested development of sheep strongyles: onset and resumption under field conditions of Central Europe

    Czech Academy of Sciences Publication Activity Database

    Langrová, I.; Makovcová, K.; Vadlejch, J.; Jankovská, I.; Petrtýl, M.; Fechtner, J.; Keil, P.; Lytvynets, Andrej; Borkovcová, M.


    Roč. 103, č. 2 (2008), s. 387-392 ISSN 0932-0113 Institutional research plan: CEZ:AV0Z50110509 Keywords : arrested development * gastrointestinal nematodes * sheep Subject RIV: EG - Zoology Impact factor: 1.473, year: 2008

  14. 28 CFR 511.18 - When Bureau staff can arrest and detain a non-inmate. (United States)


    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false When Bureau staff can arrest and detain a non-inmate. 511.18 Section 511.18 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE... secured, using minimally necessary force and restraints, in a private area of the facility away from...

  15. Seasonal variability and influence of outdoor temperature on body temperature of cardiac arrest victims. (United States)

    Stratil, Peter; Wallmueller, Christian; Schober, Andreas; Stoeckl, Mathias; Hoerburger, David; Weiser, Christoph; Testori, Christoph; Krizanac, Danica; Spiel, Alexander; Uray, Thomas; Sterz, Fritz; Haugk, Moritz


    Mild therapeutic hypothermia is a major advance in post-resuscitation-care. Some questions remain unclear regarding the time to initiate cooling and the time to achieve target temperature below 34 °C. We examined whether seasonal variability of outside temperature influences the body temperature of cardiac arrest victims, and if this might have an effect on outcome. Patients with witnessed out-of-hospital cardiac arrests were enrolled retrospectively. Temperature variables from 4 climatic stations in Vienna were provided from the Central Institute for Meteorology and Geodynamics. Depending on the outside temperature at the scene the study participants were assigned to a seasonal group. To compare the seasonal groups a Student's t-test or Mann-Whitney U test was performed as appropriate. Of 134 patients, 61 suffered their cardiac arrest during winter, with an outside temperature below 10 °C; in 39 patients the event occurred during summer, with an outside temperature above 20 °C. Comparing the tympanic temperature recorded at hospital admission, the median of 36 °C (IQR 35.3-36.3) during summer differed significantly to winter with a median of 34.9 °C (IQR 34-35.6) (ptemperature had no impact on the time-to-target-temperature, survival rate or neurologic recovery. The seasonal variability of outside temperature influences body temperature of out-of-hospital cardiac arrest victims. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Teenagers' High Arrest Rates: Features of Young Age or Youth Poverty? (United States)

    Males, Mike A.; Brown, Elizabeth A.


    The association of more crime with youthful age is widely accepted in social science. However, a literature search revealed no studies of the age-crime relationship that controlled for young ages' economic disadvantage. This research gap is addressed using the California Criminal Justice Statistics Center's arrest detail and Census poverty…

  17. Out-of-Hospital Perimortem Cesarean Section as Resuscitative Hysterotomy in Maternal Posttraumatic Cardiac Arrest

    Directory of Open Access Journals (Sweden)

    Francesca Gatti


    Full Text Available The optimal treatment of a severe hemodynamic instability from shock to cardiac arrest in late term pregnant women is subject to ongoing studies. However, there is an increasing evidence that early “separation” between the mother and the foetus may increase the restoration of the hemodynamic status and, in the cardiac arrest setting, it may raise the likelihood of a return of spontaneous circulation (ROSC in the mother. This treatment, called Perimortem Cesarean Section (PMCS, is now termed as Resuscitative Hysterotomy (RH to better address the issue of an early Cesarean section (C-section. This strategy is in contrast with the traditional treatment of cardiac arrest characterized by the maintenance of cardiopulmonary resuscitation (CPR maneuvers without any emergent surgical intervention. We report the case of a prehospital perimortem delivery by Caesarean (C section of a foetus at 36 weeks of gestation after the mother’s traumatic cardiac arrest. Despite the negative outcome of the mother, the choice of performing a RH seems to represent up to date the most appropriate intervention to improve the outcome in both mother and foetus.

  18. Sudden cardiac arrest as a presentation of Brugada syndrome unmasked by thyroid storm

    NARCIS (Netherlands)

    Korte, Anna K M; Derde, Lennie; van Wijk, Jeroen; Tjan, David H


    An 18-year-old man suffered a sudden cardiac arrest with ventricular fibrillation and was successfully resuscitated. He had neither a medical nor family history of cardiac disease/sudden death, but was known to have Graves' disease, for which he was treated with radioactive iodine. Recently,

  19. The role of baculovirus apoptotic suppressors in AcMNPV-mediated translation arrest in Ld652Y cells

    International Nuclear Information System (INIS)

    Thiem, Suzanne M.; Chejanovsky, Nor


    Infecting the insect cell line IPLB-Ld652Y with the baculovirus Autographa californica multinucleocapsid nucleopolyhedrovirus (AcMNPV) results in global translation arrest, which correlates with the presence of the AcMNPV apoptotic suppressor, p35. In this study, we investigated the role of apoptotic suppression on AcMNPV-induced translation arrest. Infecting cells with AcMNPV bearing nonfunctional mutant p35 did not result in global translation arrest. In contrast, global translation arrest was observed in cells infected with AcMNPV in which p35 was replaced with Opiap, Cpiap, or p49, baculovirus apoptotic suppressors that block apoptosis by different mechanisms than p35. These results indicated that suppressing apoptosis triggered translation arrest in AcMNPV-infected Ld652Y cells. Experiments using the DNA synthesis inhibitor aphidicolin and temperature shift experiments, using the AcMNPV replication mutants ts8 and ts8Δp35, indicated that translation arrest initiated during the early phase of infection, but events during the late phase were required for global translation arrest. Peptide caspase inhibitors could not substitute for baculovirus apoptotic suppressors to induce translation arrest in Ld652Y cells infected with a p35-null virus. However, if the p35-null-AcMNPV also carried hrf-1, a novel baculovirus host range gene, progeny virus was produced and treatment with peptide caspase inhibitors enhanced translation of a late viral gene transcript. Together, these results indicate that translation arrest in AcMNPV-infected Ld652Y cells is due to the anti-apoptotic function of p35, but suggests that rather than simply preventing caspase activation, its activity enhances signaling to a separate translation arrest pathway, possibly by stimulating the late stages of the baculovirus infection cycle

  20. Detoxification with hemabsorption after cardiac arrest does not improve neurologic recovery. Review and outcome study in dogs. (United States)

    Sterz, F; Safar, P; Diven, W; Leonov, Y; Radovsky, A; Oku, K


    We and others hypothesized that noxious substances released after prolonged cardiac arrest from malfunctioning liver, kidneys, or intestine (e.g. bacterial toxins, aromatic amino acids), might hamper recovery of the brain. The highly detoxifying effect of hemabsorption (i.e. hemoperfusion) with microencapsulated activated carbon has been demonstrated in other diseases. We used our dog model of ventricular fibrillation cardiac arrest of 15 min (n = 2 x 4) or 12.5 min (n = 2 x 6), reversed by brief (high flow) cardiopulmonary bypass (CPB). In half of the dogs in each insult group, a charcoal filter (HemoKart) was inserted into the circuit of CPB at low flow, from start of reperfusion to 4 h. Intermittent positive pressure ventilation was to 20 h and intensive care to 96 h after cardiac arrest. Bacterial blood cultures were positive in most of the dogs in both groups 30 min to 20 h after cardiac arrest (but not later) and were uninfluenced by hemabsorption. In the control groups to 4 h after cardiac arrest, serum levels of potentially injurious aromatic amino acids (e.g. phenylalanine, tyrosine) and of branched-chain/aromatic amino acid ratios, remained unchanged. From 12 to 48 h after cardiac arrest, aromatic amino acid levels increased (worsened). The branched-chain/aromatic amino acid ratios changed accordingly in the opposite direction. In the hemabsorption groups to 4 h after cardiac arrest, all amino acid levels were reduced, aromatic amino acids more so than branched-chain amino acids, thus increasing (improving) the ratio, compared with controls (P arrest, were not significantly different between groups. The lack of a beneficial outcome effect of hemabsorption to 4 h after cardiac arrest does not support the self-intoxication hypothesis. The amino acid levels later after cardiac arrest suggest that more prolonged hemabsorption and more encompassing detoxification treatments, such as plasma phoresis or total body blood washout, might be evaluated.

  1. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. (United States)

    Kudenchuk, Peter J; Brown, Siobhan P; Daya, Mohamud; Rea, Thomas; Nichol, Graham; Morrison, Laurie J; Leroux, Brian; Vaillancourt, Christian; Wittwer, Lynn; Callaway, Clifton W; Christenson, James; Egan, Debra; Ornato, Joseph P; Weisfeldt, Myron L; Stiell, Ian G; Idris, Ahamed H; Aufderheide, Tom P; Dunford, James V; Colella, M Riccardo; Vilke, Gary M; Brienza, Ashley M; Desvigne-Nickens, Patrice; Gray, Pamela C; Gray, Randal; Seals, Norman; Straight, Ron; Dorian, Paul


    Antiarrhythmic drugs are used commonly in out-of-hospital cardiac arrest for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, but without proven survival benefit. In this randomized, double-blind trial, we compared parenteral amiodarone, lidocaine, and saline placebo, along with standard care, in adults who had nontraumatic out-of-hospital cardiac arrest, shock-refractory ventricular fibrillation or pulseless ventricular tachycardia after at least one shock, and vascular access. Paramedics enrolled patients at 10 North American sites. The primary outcome was survival to hospital discharge; the secondary outcome was favorable neurologic function at discharge. The per-protocol (primary analysis) population included all randomly assigned participants who met eligibility criteria and received any dose of a trial drug and whose initial cardiac-arrest rhythm of ventricular fibrillation or pulseless ventricular tachycardia was refractory to shock. In the per-protocol population, 3026 patients were randomly assigned to amiodarone (974), lidocaine (993), or placebo (1059); of those, 24.4%, 23.7%, and 21.0%, respectively, survived to hospital discharge. The difference in survival rate for amiodarone versus placebo was 3.2 percentage points (95% confidence interval [CI], -0.4 to 7.0; P=0.08); for lidocaine versus placebo, 2.6 percentage points (95% CI, -1.0 to 6.3; P=0.16); and for amiodarone versus lidocaine, 0.7 percentage points (95% CI, -3.2 to 4.7; P=0.70). Neurologic outcome at discharge was similar in the three groups. There was heterogeneity of treatment effect with respect to whether the arrest was witnessed (P=0.05); active drugs were associated with a survival rate that was significantly higher than the rate with placebo among patients with bystander-witnessed arrest but not among those with unwitnessed arrest. More amiodarone recipients required temporary cardiac pacing than did recipients of lidocaine or placebo. Overall, neither

  2. Identification of Fitness Determinants during Energy-Limited Growth Arrest in Pseudomonas aeruginosa. (United States)

    Basta, David W; Bergkessel, Megan; Newman, Dianne K


    Microbial growth arrest can be triggered by diverse factors, one of which is energy limitation due to scarcity of electron donors or acceptors. Genes that govern fitness during energy-limited growth arrest and the extent to which they overlap between different types of energy limitation are poorly defined. In this study, we exploited the fact that Pseudomonas aeruginosa can remain viable over several weeks when limited for organic carbon (pyruvate) as an electron donor or oxygen as an electron acceptor. ATP values were reduced under both types of limitation, yet more severely in the absence of oxygen. Using transposon-insertion sequencing (Tn-seq), we identified fitness determinants in these two energy-limited states. Multiple genes encoding general functions like transcriptional regulation and energy generation were required for fitness during carbon or oxygen limitation, yet many specific genes, and thus specific activities, differed in their relevance between these states. For instance, the global regulator RpoS was required during both types of energy limitation, while other global regulators such as DksA and LasR were required only during carbon or oxygen limitation, respectively. Similarly, certain ribosomal and tRNA modifications were specifically required during oxygen limitation. We validated fitness defects during energy limitation using independently generated mutants of genes detected in our screen. Mutants in distinct functional categories exhibited different fitness dynamics: regulatory genes generally manifested a phenotype early, whereas genes involved in cell wall metabolism were required later. Together, these results provide a new window into how P. aeruginosa survives growth arrest. IMPORTANCE Growth-arrested bacteria are ubiquitous in nature and disease yet understudied at the molecular level. For example, growth-arrested cells constitute a major subpopulation of mature biofilms, serving as an antibiotic-tolerant reservoir in chronic

  3. Costunolide causes mitotic arrest and enhances radiosensitivity in human hepatocellular carcinoma cells

    International Nuclear Information System (INIS)

    Liu, Chia-Yuan; Chang, Hsun-Shuo; Chen, Ih-Sheng; Chen, Chih-Jen; Hsu, Ming-Ling; Fu, Shu-Ling; Chen, Yu-Jen


    This work aimed to investigate the effect of costunolide, a sesquiterpene lactone isolated from Michelia compressa, on cell cycle distribution and radiosensitivity of human hepatocellular carcinoma (HCC) cells. The assessment used in this study included: cell viability assay, cell cycle analysis by DNA histogram, expression of phosphorylated histone H3 (Ser 10) by flow cytometer, mitotic index by Liu's stain and morphological observation, mitotic spindle alignment by immunofluorescence of alpha-tubulin, expression of cell cycle-related proteins by Western blotting, and radiation survival by clonogenic assay. Our results show that costunolide reduced the viability of HA22T/VGH cells. It caused a rapid G2/M arrest at 4 hours shown by DNA histogram. The increase in phosphorylated histone H3 (Ser 10)-positive cells and mitotic index indicates costunolide-treated cells are arrested at mitosis, not G2, phase. Immunofluorescence of alpha-tubulin for spindle formation further demonstrated these cells are halted at metaphase. Costunolide up-regulated the expression of phosphorylated Chk2 (Thr 68), phosphorylated Cdc25c (Ser 216), phosphorylated Cdk1 (Tyr 15) and cyclin B1 in HA22T/VGH cells. At optimal condition causing mitotic arrest, costunolide sensitized HA22T/VGH HCC cells to ionizing radiation with sensitizer enhancement ratio up to 1.9. Costunolide could reduce the viability and arrest cell cycling at mitosis in hepatoma cells. Logical exploration of this mitosis-arresting activity for cancer therapeutics shows costunolide enhanced the killing effect of radiotherapy against human HCC cells

  4. Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest in children after cardiac surgery. (United States)

    Erek, Ersin; Aydın, Selim; Suzan, Dilek; Yıldız, Okan; Altın, Fırat; Kırat, Barış; Demir, Ibrahim Halil; Ödemiş, Ender


    Extracorporeal membrane oxygenation (ECMO) is used to provide cardiorespiratory support during cardiopulmonary resuscitation (extracorporeal cardiopulmonary resuscitation; ECPR) unresponsive to conventional methods. In this study, the results of ECPR in a cardiac arrest setting after cardiac surgery in children were analyzed. In this retrospective cohort study, between November 2010 and June 2014, 613 congenital heart operations were performed by the same surgical team. Medical records of all the patients who experienced cardiac arrest and ECPR in an early postoperative period (n=25; 4%) were analyzed. Their ages were between 2 days and 4.5 years (median: 3 months). Sixteen patients had palliative procedures. In 88% of the patients, cardiac arrest episodes occurred in the first 24 h after operation. Mechanical support was provided by cardiopulmonary bypass only (n=10) or by ECMO (n=15) during CPR. The CPR duration until commencing mechanical support was 40 min in 12 patients. Eleven patients (44%) were weaned successfully from ECMO and survived more than 7 days. Five of them (20%) could be discharged. The CPR duration before ECMO (p=0.01) and biventricular physiology (p=0.022) was the key factor affecting survival. The follow-up duration was a mean of 15±11.9 months. While four patients were observed to have normal neuromotor development, one patient died of cerebral bleeding 6 months after discharge. Postoperative cardiac arrest usually occurs in the first 24 h after operation. ECPR provides a second chance for survival in children who have had cardiac arrest. Shortening the duration of CPR before ECMO might increase survival rates.

  5. Dynamical arrest, percolation, gelation, and glass formation in model nanoparticle dispersions with thermoreversible adhesive interactions. (United States)

    Eberle, Aaron P R; Castañeda-Priego, Ramón; Kim, Jung M; Wagner, Norman J


    We report an experimental study of the dynamical arrest transition for a model system consisting of octadecyl coated silica suspended in n-tetradecane from dilute to concentrated conditions spanning the state diagram. The dispersion's interparticle potential is tuned by temperature affecting the brush conformation leading to a thermoreversible model system. The critical temperature for dynamical arrest, T*, is determined as a function of dispersion volume fraction by small-amplitude dynamic oscillatory shear rheology. We corroborate this transition temperature by measuring a power-law decay of the autocorrelation function and a loss of ergodicity via fiber-optic quasi-elastic light scattering. The structure at T* is measured using small-angle neutron scattering. The scattering intensity is fit to extract the interparticle pair-potential using the Ornstein-Zernike equation with the Percus-Yevick closure approximation, assuming a square-well interaction potential with a short-range interaction (1% of particle diameter). (1) The strength of attraction is characterized using the Baxter temperature (2) and mapped onto the adhesive hard sphere state diagram. The experiments show a continuous dynamical arrest transition line that follows the predicted dynamical percolation line until ϕ ≈ 0.41 where it subtends the predictions toward the mode coupling theory attractive-driven glass line. An alternative analysis of the phase transition through the reduced second virial coefficient B(2)* shows a change in the functional dependence of B(2)* on particle concentration around ϕ ≈ 0.36. We propose this signifies the location of a gel-to-glass transition. The results presented herein differ from those observed for depletion flocculated dispersion of micrometer-sized particles in polymer solutions, where dynamical arrest is a consequence of multicomponent phase separation, suggesting dynamical arrest is sensitive to the physical mechanism of attraction.

  6. Growth-arrest-specific protein 2 inhibits cell division in Xenopus embryos.

    Directory of Open Access Journals (Sweden)

    Tong Zhang

    Full Text Available Growth-arrest-specific 2 gene was originally identified in murine fibroblasts under growth arrest conditions. Furthermore, serum stimulation of quiescent, non-dividing cells leads to the down-regulation of gas2 and results in re-entry into the cell cycle. Cytoskeleton rearrangements are critical for cell cycle progression and cell division and the Gas2 protein has been shown to co-localize with actin and microtubules in interphase mammalian cells. Despite these findings, direct evidence supporting a role for Gas2 in the mechanism of cell division has not been reported.To determine whether the Gas2 protein plays a role in cell division, we over-expressed the full-length Gas2 protein and Gas2 truncations containing either the actin-binding CH domain or the tubulin-binding Gas2 domain in Xenopus laevis embryos. We found that both the full-length Gas2 protein and the Gas2 domain, but not the CH domain, inhibited cell division and resulted in multinucleated cells. The observation that Gas2 domain alone can arrest cell division suggests that Gas2 function is mediated by microtubule binding. Gas2 co-localized with microtubules at the cell cortex of Gas2-injected Xenopus embryos using cryo-confocal microscopy and co-sedimented with microtubules in cytoskeleton co-sedimentation assays. To investigate the mechanism of Gas2-induced cell division arrest, we showed, using a wound-induced contractile array assay, that Gas2 stabilized microtubules. Finally, electron microscopy studies demonstrated that Gas2 bundled microtubules into higher-order structures.Our experiments show that Gas2 inhibits cell division in Xenopus embryos. We propose that Gas2 function is mediated by binding and bundling microtubules, leading to cell division arrest.

  7. Association between a quantitative CT scan measure of brain edema and outcome after cardiac arrest. (United States)

    Metter, Robert B; Rittenberger, Jon C; Guyette, Francis X; Callaway, Clifton W


    Cerebral edema is one physical change associated with brain injury and decreased survival after cardiac arrest. Edema appears on computed tomography (CT) scan of the brain as decreased X-ray attenuation by gray matter. This study tested whether the gray matter attenuation to white matter attenuation ratio (GWR) was associated with survival and functional recovery. Subjects were patients hospitalized after cardiac arrest at a single institution between 1/1/2005 and 7/30/2010. Subjects were included if they had non-traumatic cardiac arrest and a non-contrast CT scan within 24h after cardiac arrest. Attenuation (Hounsfield Units) was measured in gray matter (caudate nucleus, putamen, thalamus, and cortex) and in white matter (internal capsule, corpus callosum and centrum semiovale). The GWR was calculated for basal ganglia and cerebrum. Outcomes included survival and functional status at hospital discharge. For 680 patients, 258 CT scans were available, but 18 were excluded because of hemorrhage (10), intravenous contrast (3) or technical artifact (5), leaving 240 CT scans for analysis. Lower GWR values were associated with lower initial Glasgow Coma Scale motor score. Overall survival was 36%, but decreased with decreasing GWR. The average of basal ganglia and cerebrum GWR provided the best discrimination. Only 2/58 subjects with average GWR<1.20 survived and both were treated with hypothermia. The association of GWR with functional outcome was completely explained by mortality when GWR<1.20. Subjects with severe cerebral edema, defined by GWR<1.20, have very low survival with conventional care, including hypothermia. GWR estimates pre-treatment likelihood of survival after cardiac arrest. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest. (United States)

    Ringh, Mattias; Rosenqvist, Mårten; Hollenberg, Jacob; Jonsson, Martin; Fredman, David; Nordberg, Per; Järnbert-Pettersson, Hans; Hasselqvist-Ax, Ingela; Riva, Gabriel; Svensson, Leif


    Cardiopulmonary resuscitation (CPR) performed by bystanders is associated with increased survival rates among persons with out-of-hospital cardiac arrest. We investigated whether rates of bystander-initiated CPR could be increased with the use of a mobile-phone positioning system that could instantly locate mobile-phone users and dispatch lay volunteers who were trained in CPR to a patient nearby with out-of-hospital cardiac arrest. We conducted a blinded, randomized, controlled trial in Stockholm from April 2012 through December 2013. A mobile-phone positioning system that was activated when ambulance, fire, and police services were dispatched was used to locate trained volunteers who were within 500 m of patients with out-of-hospital cardiac arrest; volunteers were then dispatched to the patients (the intervention group) or not dispatched to them (the control group). The primary outcome was bystander-initiated CPR before the arrival of ambulance, fire, and police services. A total of 5989 lay volunteers who were trained in CPR were recruited initially, and overall 9828 were recruited during the study. The mobile-phone positioning system was activated in 667 out-of-hospital cardiac arrests: 46% (306 patients) in the intervention group and 54% (361 patients) in the control group. The rate of bystander-initiated CPR was 62% (188 of 305 patients) in the intervention group and 48% (172 of 360 patients) in the control group (absolute difference for intervention vs. control, 14 percentage points; 95% confidence interval, 6 to 21; Pmobile-phone positioning system to dispatch lay volunteers who were trained in CPR was associated with significantly increased rates of bystander-initiated CPR among persons with out-of-hospital cardiac arrest. (Funded by the Swedish Heart-Lung Foundation and Stockholm County; number, NCT01789554.).

  9. Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support. (United States)

    Sanghavi, Prachi; Jena, Anupam B; Newhouse, Joseph P; Zaslavsky, Alan M


    Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited. To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest. Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases). Propensity score methods were used to compare the effects of ALS and BLS on patient survival, neurological performance, and medical spending after cardiac arrest. Survival to hospital discharge, to 30 days, and to 90 days; neurological performance; and incremental medical spending per additional survivor to 1 year. Survival to hospital discharge was greater among patients receiving BLS (13.1% vs 9.2% for ALS; 4.0 [95% CI, 2.3-5.7] percentage point difference), as was survival to 90 days (8.0% vs 5.4% for ALS; 2.6 [95% CI, 1.2-4.0] percentage point difference). Basic life support was associated with better neurological functioning among hospitalized patients (21.8% vs 44.8% with poor neurological functioning for ALS; 23.0 [95% CI, 18.6-27.4] percentage point difference). Incremental medical spending per additional survivor to 1 year for BLS relative to ALS was $154,333. Patients with out-of-hospital cardiac arrest who received BLS had higher survival at hospital discharge and at 90 days compared with those who received ALS and were less likely to experience poor neurological functioning.

  10. Hemodynamic effects of nitric oxide synthase inhibition before and after cardiac arrest in infant piglets. (United States)

    Schleien, C L; Kuluz, J W; Gelman, B


    Using infant piglets, we studied the effects of nonspecific inhibition of nitric oxide (NO) synthase by NG-nitro-L-arginine methyl ester (L-NAME; 3 mg/kg) on vascular pressures, regional blood flow, and cerebral metabolism before 8 min of cardiac arrest, during 6 min of cardiopulmonary resuscitation (CPR), and at 10 and 60 min of reperfusion. We tested the hypotheses that nonspecific NO synthase inhibition 1) will attenuate early postreperfusion hyperemia while still allowing for successful resuscitation after cardiac arrest, 2) will allow for normalization of blood flow to the kidneys and intestines after cardiac arrest, and 3) will maintain cerebral metabolism in the face of altered cerebral blood flow after reperfusion. Before cardiac arrest, L-NAME increased vascular pressures and cardiac output and decreased blood flow to brain (by 18%), heart (by 36%), kidney (by 46%), and intestine (by 52%) compared with placebo. During CPR, myocardial flow was maintained in all groups to successfully resuscitate 24 of 28 animals [P value not significant (NS)]. Significantly, L-NAME attenuated postresuscitation hyperemia in cerebellum, diencephalon, anterior cerebral, and anterior-middle watershed cortical brain regions and to the heart. Likewise, cerebral metabolic rates of glucose (CMRGluc) and of lactate production (CMRLac) were not elevated at 10 min of reperfusion. These cerebral blood flow and metabolic effects were reversed by L-arginine. Flows returned to baseline levels by 60 min of reperfusion. Kidney and intestinal flow, however, remained depressed throughout reperfusion in all three groups. Thus nonspecific inhibition of NO synthase did not adversely affect the rate of resuscitation from cardiac arrest while attenuating cerebral and myocardial hyperemia. Even though CMRGluc and CMRLac early after resuscitation were decreased, they were maintained at baseline levels. This may be clinically advantageous in protecting the brain and heart from the damaging effects of

  11. Management of simulated maternal cardiac arrest by residents: didactic teaching versus electronic learning. (United States)

    Hards, Andrea; Davies, Sharon; Salman, Aliya; Erik-Soussi, Magda; Balki, Mrinalini


    Successful resuscitation of a pregnant woman undergoing cardiac arrest and survival of the fetus require prompt, high-quality cardiopulmonary resuscitation. The objective of this observational study was to assess management of maternal cardiac arrest by anesthesia residents using high-fidelity simulation and compare subsequent performance following either didactic teaching or electronic learning (e-learning). Twenty anesthesia residents were randomized to receive either didactic teaching (Didactic group, n = 10) or e-learning (Electronic group, n = 10) on maternal cardiac arrest. Baseline management skills were tested using high-fidelity simulation, with repeat simulation testing one month after their teaching intervention. The time from cardiac arrest to start of perimortem Cesarean delivery (PMCD) was measured, and the technical and nontechnical skills scores between the two teaching groups were compared. The median [interquartile range] time to PMCD decreased after teaching, from 4.5 min [3.4 to 5.1 min] to 3.5 min [2.5 to 4.0 min] (P = 0.03), although the change within each group was not statistically significant (Didactic group 4.9 to 3.8 min, P = 0.2; Electronic group 3.9 to 2.5 min, P = 0.07; Didactic group vs Electronic group, P = 1.0). Even after teaching, only 65% of participants started PMCD within four minutes. Technical and nontechnical skills scores improved after teaching in both groups, and there were no differences between the groups. There are gaps in the knowledge and implementation of resuscitation protocols and the recommended modifications for pregnancy among residents. Teaching can improve performance during management of maternal cardiac arrest. Electronic learning and didactic teaching offer similar benefits.

  12. Crack-arrest tests on two irradiated high-copper welds

    International Nuclear Information System (INIS)

    Iskander, S.K.; Corwin, W.R.; Nanstad, R.K.


    The objective of the Heavy-Section Steel Irradiation Program Sixth Irradiation Series is to determine the effect of neutron irradiation on the shift and shape of the lower-bound curve to crack-arrest toughness data. Two submerged-arc welds with copper contents of 0.23 and 0.31 wt % were commercially fabricated in 220-mm-thick plate. Crack-arrest specimens fabricated from these welds were irradiated at a nominal temperature of 288 degrees C to an average fluence of 1.9 x 10 19 neutrons/cm 2 (>1 MeV). This is the second report giving the results of the tests on irradiated duplex-type crack-arrest specimens. A previous report gave results of tests on irradiated weld-embrittled-type specimens. Charpy V-notch (CVN) specimens irradiated in the same capsules as the crack-arrest specimens were also tested, and a 41-J transition temperature shift was determined from these specimens. open-quotes Mean close-quote curves of the same form as the American Society of Mechanical Engineers (ASME) K la curve were fit to the data with only the open-quotes reference temperatureclose quotes as a parameter. The shift between the mean curves agrees well with the 41-J transition temperature shift obtained from the CVN specimen tests. Moreover, the four data points resulting from tests on the duplex crack-arrest specimens of the present study did not make a significant change to mean curve fits to either the previously obtained data or all the data combined

  13. Recently Arrested Adolescents are at High Risk for Sexually Transmitted Diseases (United States)

    Belenko, Steven; Dembo, Richard; Weiland, Doris; Rollie, Matthew; Salvatore, Christopher; Hanlon, Alexandra; Childs, Kristina


    Background Adolescent offenders may be at high risk for sexually transmitted diseases (STDs). With previous research and interventions focused on incarcerated adolescents, data are needed on STD prevalence and risk factors among newly arrested youth released to the community, a far larger subgroup. Methods Participants were recruited from all arrested youth processed at the Hillsborough County, Florida Juvenile Assessment Center during the last half of 2006 (506 males, 442 females). Participants voluntarily providing urine samples for drug testing as part of standard protocol were also consented to having their specimens split and tested for chlamydia and gonorrhea, using an FDA-approved nucleic acid amplification test. Results STD prevalence was similar to those previously reported among incarcerated adolescents: 11.5% tested positive for chlamydia, 4.2% for gonorrhea, and 13.2% for either or both infections. Prevalence was significantly higher among females: 19.2% of females had either or both infections compared with 10.5% of males. Prevalence was higher for 17 to 18 year olds (15.2% of males, 25.5% of females), blacks, detained youths, drug users, and those engaged in sexual risk behaviors. Previous STD testing experience was limited. Conclusions The study indicated that a voluntary STD screening protocol is feasible for arrested youth entering the juvenile justice system, and these offenders are at high risk for STDs. Because most arrested youths are released back to the community, routine testing and treatment of recently arrested youths, and expanded access to risk reduction and prevention programs, can yield substantial public health benefits. PMID:18461014

  14. Dynamic arrest in a liquid of symmetric dumbbells: reorientational hopping for small molecular elongations. (United States)

    Moreno, Angel J; Chong, Song-Ho; Kob, Walter; Sciortino, Francesco


    We present extensive equilibrium and out-of-equilibrium molecular-dynamics simulations of a liquid of symmetric dumbbell molecules, for constant packing fraction, as a function of temperature and molecular elongation. We compute diffusion constants as well as odd and even orientational correlators. The notations odd and even refer to the parity of the order l of the corresponding Legendre l polynomial, evaluated for the orientation of the molecular axis relative to its initial position. Rotational degrees of freedom of order l are arrested if, in the long-time limit, the corresponding orientational l correlator does not decay to zero. It is found that for large elongations translational and rotational degrees of freedom freeze at the same temperature. For small elongations only the even rotational degrees of freedom remain coupled to translational motions and arrest at a finite common temperature. On the contrary, the odd rotational degrees of freedom remain ergodic at all investigated temperatures. Hence, in the translationally arrested state, each molecule remains trapped in the cage formed by its neighboring molecules, but is able to perform 180 degrees rotations, which lead to relaxation only for the odd orientational correlators. The temperature dependence of the characteristic time of these residual rotations is well described by an Arrhenius law. Finally, we discuss the evidence in favor of the presence of the type-A transition for the odd rotational degrees of freedom, as predicted by mode-coupling theory for small molecular elongations. This transition is distinct from the type-B transition, associated with the arrest of the translational and even rotational degrees of freedom for small elongations, and with all degrees of freedom for large elongations. Odd orientational correlators are computed for small elongations at very low temperatures in the translationally arrested state. The obtained results suggest that hopping events restore the ergodicity of

  15. Paramedic Intubation Experience Is Associated With Successful Tube Placement but Not Cardiac Arrest Survival. (United States)

    Dyson, Kylie; Bray, Janet E; Smith, Karen; Bernard, Stephen; Straney, Lahn; Nair, Resmi; Finn, Judith


    Paramedic experience with intubation may be an important factor in skill performance and patient outcomes. Our objective is to examine the association between previous intubation experience and successful intubation. In a subcohort of out-of-hospital cardiac arrest cases, we also measure the association between patient survival and previous paramedic intubation experience. We analyzed data from Ambulance Victoria electronic patient care records and the Victorian Ambulance Cardiac Arrest Registry for January 1, 2008, to September 26, 2014. For each patient case, we defined intubation experience as the number of intubations attempted by each paramedic in the previous 3 years. Using logistic regression, we estimated the association between intubation experience and (1) successful intubation and (2) first-pass success. In the out-of-hospital cardiac arrest cohort, we determined the association between previous intubation experience and patient survival. During the 6.7-year study period, 769 paramedics attempted intubation in 14,857 patients. Paramedics typically performed 3 intubations per year (interquartile range 1 to 6). Most intubations were successful (95%), including 80% on the first attempt. Previous intubation experience was associated with intubation success (odds ratio 1.04; 95% confidence interval 1.03 to 1.05) and intubation first-pass success (odds ratio 1.02; 95% confidence interval 1.01 to 1.03). In the out-of-hospital cardiac arrest subcohort (n=9,751), paramedic intubation experience was not associated with patient survival. Paramedics in this Australian cohort performed few intubations. Previous experience was associated with successful intubation. Among out-of-hospital cardiac arrest patients for whom intubation was attempted, previous paramedic intubation experience was not associated with patient survival. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  16. Domains of nursing intervention after sudden cardiac arrest and automatic internal cardioverter defibrillator implantation. (United States)

    Dougherty, C M; Benoliel, J Q; Bellin, C


    The purpose of the study was to explore individual and family experiences after sudden cardiac arrest and automatic internal cardioverter defibrillator implantation during the first year of recovery. This report specifically addresses the domains of concern expressed and helpful strategies used by participants that are relevant to the development of future intervention programs. A grounded theory approach was used to gain an understanding of areas of concern of sudden cardiac arrest survivors and families that could be used when designing future nursing interventions. Semistructured interviews were conducted with both sudden cardiac arrest survivors and 1 family member each at 5 points during the first year of recovery (hospitalization; 1, 3, 6, and 12 months after hospitalization). Participants were asked to identify those specific areas that most concerned them and that they would like assistance with during the first year. A total of 150 interviews were conducted with 176 hours of data generated. The study focused on 10 northwest urban community medical centers and participants' homes within a 50-mile driving distance from the medical centers. The sample included 15 first-time sudden cardiac arrest survivors (13 men and 2 women) and 1 family member each between the ages of 31 and 72 years. Domains of concern identified by participants that can be used to design future nursing intervention programs included preventive care, dealing with automatic internal cardioverter defibrillator shocks, emotional challenges, physical changes, activities of daily living, partner relationships, and dealing with health care providers. Suggestions of helpful strategies used by participants during the first year are outlined. Domains of concern and helpful strategies identified by participants provide a framework for the development and testing of nursing intervention programs to enhance recovery following sudden cardiac arrest for survivors and their families.

  17. Comparison of Medical Priority Dispatch (MPD) and Criteria Based Dispatch (CBD) relating to cardiac arrest calls. (United States)

    Hardeland, Camilla; Olasveengen, Theresa M; Lawrence, Rob; Garrison, Danny; Lorem, Tonje; Farstad, Gunnar; Wik, Lars


    Prompt emergency medical service (EMS) system activation with rapid delivery of pre-hospital treatment is essential for patients suffering out-of-hospital cardiac arrest (OHCA). The two most commonly used dispatch tools are Medical Priority Dispatch (MPD) and Criteria Based Dispatch (CBD). We compared cardiac arrest call processing using these two dispatch tools in two different dispatch centres. Observational study of adult EMS confirmed (non-EMS witnessed) OHCA calls during one year in Richmond, USA (MPD) and Oslo, Norway (CBD). Patients receiving CPR prior to call, interrupted calls or calls where the caller did not have access to the patients were excluded from analysis. Dispatch logs, ambulance records and digitalized dispatcher and caller voice recordings were compared. The MPDS-site processed 182 cardiac arrest calls and the CBD-site 232, of which 100 and 140 calls met the inclusion criteria, respectively. The recognition of cardiac arrest was not different in the MPD and CBD systems; 82% vs. 77% (p=0.42), and pre-EMS arrival CPR instructions were offered to 81% vs. 74% (p=0.22) of callers, respectively. Time to ambulance dispatch was median (95% confidence interval) 15 (13, 17) vs. 33 (29, 36) seconds (pCBD systems, respectively (p=0.05). Pre-arrival CPR instructions were offered faster and more frequently in the CBD system, but in both systems chest compressions were delayed 3-4min. Earlier recognition of cardiac arrest and improved CPR instructions may facilitate earlier lay rescuer CPR. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Effect of four resuscitation methods on lung ventilation of pigs with respiratory arrest

    Directory of Open Access Journals (Sweden)

    Ya-hua LIU


    Full Text Available Objective To observe the effects of four cardiopulmonary resuscitation (CPR methods on lung ventilation of pigs with respiratory arrest. The four CPR methods included chest compression CPR (C-CPR, compression under the diaphragm CPR (D-CPR, abdominal compression CPR (A-CPR, and abdominal wall lifting and compression CPR (L-CPR. Methods  A total of 28 healthy domestic pigs were randomly divided into four groups. The pig respiratory arrest model was reproduced by intravenous injection of suxamethonium. Instantly after respiratory arrest, one of the 4 CPR methods was performed immediately on the groups of pigs respectively. After 2min of CPR, compression was stopped. The experimental pigs were given assisted respiration using a ventilator until autonomous respiration recovered. The tidal volume (VT in basic status and that during resuscitation by the four respective resuscitation methods was determined, and minute ventilation (MV was calculated. Furthermore, heart rate (HR, mean arterial blood pressure, and recovery time of autonomous respiration were compared between all the groups. Results In basic status, there was no statistical difference (P > 0.05 in VT and MV between the four groups. Approximately 2min after resuscitation, the VT and MV of D-CPR were higher than that of C-CPR; that of A-CPR was higher than that of D-CPR; and that of L-CPR was higher than that of A-CPR. The differences were statistically significant (P 0.05. HR in C-CPR and D-CPR were notably lower than the basic value (P < 0.01. Two minutes after resuscitation, mechanical ventilation was given, and HR in all the groups was close to the basic value 5 min after resuscitation. In the respiratory arrest pig model, L-CPR could provide more effective VT and MV than the other methods. Conclusion For the porcine respiratory arrest model, L-CPR can provide more effective lung ventilation than the other methods.

  19. Acute kidney injury after cardiac arrest: a systematic review and meta-analysis of clinical studies. (United States)

    Sandroni, Claudio; Dell'anna, Antonio M; Tujjar, Omar; Geri, Guillaume; Cariou, Alain; Taccone, Fabio S


    The prevalence of and the risk factors for acute kidney injury (AKI) after cardiac arrest (CA), and the association of AKI with outcome have not been systematically investigated so far. In this systematic review and meta-analysis, studies on adult patients (dating from January 1966 to August 2015) published as full-text articles were screened. Two authors independently extracted data and assessed study quality using the Quality Assessment Tool of the U.S. National Institute of Health. Data were summarized using weighted means. Eight studies (total 1693 patients; 68% males) were included. The incidence of AKI was 37%. In six studies where a standard AKI definition (RIFLE, AKIN or KDIGO) was used, the incidence for AKI stage 1 or higher was 52%. AKI occurred at a median of 1-2 days from cardiac arrest in 6/8 studies. Renal replacement therapy (RRT) was used in 239 AKI patients (33%), of whom five (2%) still needed RRT at 30 days after CA. An initial non-shockable rhythm, a longer duration of arrest, higher creatinine levels on admission, and the presence of shock or higher blood lactate after resuscitation were significant predictors of AKI occurrence. Hospital mortality was significantly higher in AKI vs. non-AKI patients (OR 2.63 [1.86-3.68]; Passociated with increased mortality. Decreased renal function on admission, an initial non-shockable rhythm and both pre-arrest and post-arrest markers of hypoperfusion are associated with increased risk of AKI in this setting.

  20. Hospital Variation in Survival Trends for In‐hospital Cardiac Arrest (United States)

    Girotra, Saket; Cram, Peter; Spertus, John A.; Nallamothu, Brahmajee K.; Li, Yan; Jones, Philip G.; Chan, Paul S.


    Background During the past decade, survival after in‐hospital cardiac arrest has improved markedly. It remains unknown whether the improvement in survival has occurred uniformly at all hospitals or was driven by large improvements at only a few hospitals. Methods and Results We identified 93 342 adults with an in‐hospital cardiac arrest at 231 hospitals in the Get With The Guidelines®‐Resuscitation registry during 2000–2010. Using hierarchical regression models, we evaluated hospital‐level trends in survival to discharge. Mean age was 66 years, 59% were men, and 21% were black. Between 2000 and 2010, there was a significant decrease in age, prevalence of heart failure and myocardial infarction, and cardiac arrests due to shockable rhythms (Phospital rates of in‐hospital cardiac arrest survival improved by 7% per year (odds ratio [OR] 1.07, 95% CI 1.06 to 1.08, Phospital quartile to 11% in the top hospital quartile. Compared with minor teaching hospitals (OR 1.04, 95% CI 1.02 to 1.06), hospital rate of survival improvement was greater at major teaching (OR 1.08, 95% CI 1.06 to 1.10) and nonteaching hospitals (OR 1.07, 95% CI 1.05 to 1.09, P value for interaction=0.03). Conclusion Although in‐hospital cardiac arrest survival has improved during the past decade, the magnitude of improvement varied across hospitals. Future studies are needed to identify hospital processes that have led to the largest improvement in survival. PMID:24922627

  1. Clinical Trials in Cardiac Arrest and Subarachnoid Hemorrhage: Lessons from the Past and Ideas for the Future

    Directory of Open Access Journals (Sweden)

    Jennifer A. Frontera


    Full Text Available Introduction. Elevated intracranial pressure that occurs at the time of cerebral aneurysm rupture can lead to inadequate cerebral blood flow, which may mimic the brain injury cascade that occurs after cardiac arrest. Insights from clinical trials in cardiac arrest may provide direction for future early brain injury research after subarachnoid hemorrhage (SAH. Methods. A search of PubMed from 1980 to 2012 and was conducted to identify published and ongoing randomized clinical trials in aneurysmal SAH and cardiac arrest patients. Only English, adult, human studies with primary or secondary mortality or neurological outcomes were included. Results. A total of 142 trials (82 SAH, 60 cardiac arrest met the review criteria (103 published, 39 ongoing. The majority of both published and ongoing SAH trials focus on delayed secondary insults after SAH (70%, while 100% of cardiac arrest trials tested interventions within the first few hours of ictus. No SAH trials addressing treatment of early brain injury were identified. Twenty-nine percent of SAH and 13% of cardiac arrest trials showed outcome benefit, though there is no overlap mechanistically. Conclusions. Clinical trials in SAH assessing acute brain injury are warranted and successful interventions identified by the cardiac arrest literature may be reasonable targets of the study.

  2. Factors predicting quality of life and societal participation after survival of a cardiac arrest: A prognostic longitudinal cohort study. (United States)

    Verberne, Daan; Moulaert, Véronique; Verbunt, Jeanine; van Heugten, Caroline


    For those patients who suffer unfavourable outcome after survival of cardiac arrest, it is important to know whether this can be predicted at an early stage. Support can subsequently be provided. This study aimed to identify early prognostic factors of quality of life (QOL) and societal participation at one year post-cardiac arrest. The design was a prospective longitudinal cohort study following cardiac arrest survivors up to one year. Prognostic personal, injury-related, function-related and subjective outcome factors were selected and entered into a hierarchical regression model to assess whether they were predictive of QOL and societal participation at one year post-cardiac arrest. Hundred and ten cardiac arrest survivors were included. Not having a partner, more functional limitations (at two weeks) and cognitive complaints were significantly predictive of lower physical QOL, while higher levels of anxiety and depression symptoms (at three months) were significant predictors of mental QOL. A neurological history and higher levels of anxiety and depression symptoms were significantly predictive of lower brain injury-specific QOL. Societal participation was only predicted by premorbid functioning. This study identified prognostic factors of QOL and societal participation one year after survival of cardiac arrest. Screening of these factors in early stages can identify those survivors with possibly unfavourable QOL at one year post cardiac arrest. For those survivors, preventive and targeted interventions may be offered. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Berberine, a genotoxic alkaloid, induces ATM-Chk1 mediated G2 arrest in prostate cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    Wang Yu; Liu Qiao; Liu Zhaojian; Li Boxuan; Sun Zhaoliang; Zhou Haibin; Zhang Xiyu; Gong Yaoqin [Ministry of Education Key Laboratory of Experimental Teratology and Institute of Molecular Medicine and Genetics, Shandong University School of Medicine, Jinan (China); Shao Changshun, E-mail: [Ministry of Education Key Laboratory of Experimental Teratology and Institute of Molecular Medicine and Genetics, Shandong University School of Medicine, Jinan (China)


    Berberine has been shown to possess anti-tumor activity against a wide spectrum of cancer cells. It inhibits cancer cell proliferation by inducing cell cycle arrest, at G1 and/or G2/M, and apoptosis. While it has been documented that berberine induces G1 arrest by activating the p53-p21 cascade, it remains unclear what mechanism underlies the berberine-induced G2/M arrest, which is p53-independent. In this study, we tested the anti-proliferative effect of berberine on murine prostate cancer cell line RM-1 and characterized the underlying mechanisms. Berberine dose-dependently induced DNA double-strand breaks and apoptosis. At low concentrations, berberine was observed to induce G1 arrest, concomitant with the activation of p53-p21 cascade. Upon exposure to berberine at a higher concentration (50 {mu}M) for 24 h, cells exhibited G2/M arrest. Pharmacological inhibition of ATM by KU55933, or Chk1 by UCN-01, could efficiently abrogate the G2/M arrest in berberine-treated cells. Downregulation of Chk1 by RNA interference also abolished the G2/M arrest caused by berberine, confirming the role of Chk1 in the pathway leading to G2/M arrest. Abrogation of G2/M arrest by ATM inhibition forced more cells to undergo apoptosis in response to berberine treatment. Chk1 inhibition by UCN-01, on the other hand, rendered cells more sensitive to berberine only when p53 was inhibited. Our results suggest that combined administration of berberine and caffeine, or other ATM inhibitor, may accelerate the killing of cancer cells.

  4. Use of implantable cardioverter defibrillators after out-of-hospital cardiac arrest: a prospective follow-up study (United States)

    Parkash, Ratika; Tang, Anthony; Wells, George; Blackburn, Josée; Stiell, Ian; Simpson, Christopher; Dorian, Paul; Yee, Raymond; Cameron, Doug; Connolly, Stuart; Birnie, David; Nichol, Graham


    Background Survivors of out-of-hospital cardiac arrest are at high risk of recurrent arrests, many of which could be prevented with implantable cardioverter defibrillators (ICDs). We sought to determine the ICD insertion rate among survivors of out-of-hospital cardiac arrest and to determine factors associated with ICD implantation. Methods The Ontario Prehospital Advanced Life Support (OPALS) study is a prospective, multiphase, before–after study assessing the effectiveness of prehospital interventions for people experiencing cardiac arrest, trauma or respiratory arrest in 19 Ontario communities. We linked OPALS data describing survivors of cardiac arrest with data from all defibrillator implantation centres in Ontario. Results From January 1997 to April 2002, 454 patients in the OPALS study survived to hospital discharge after experiencing an out-of-hospital cardiac arrest. The mean age was 65 (standard deviation 14) years, 122 (26.9%) were women, 398 (87.7%) had a witnessed arrest, 372 (81.9%) had an initial rhythm of ventricular tachycardia or ventricular fibrillation (VT/VF), and 76 (16.7%) had asystole or another arrhythmia. The median cerebral performance category at discharge (range 1–5, 1 = normal) was 1. Only 58 (12.8%) of the 454 patients received an ICD. Patients with an initial rhythm of VT/VF were more likely than those with an initial rhythm of asystole or another rhythm to undergo device insertion (adjusted odds ratio [OR] 9.63, 95% confidence interval [CI] 1.31–71.50). Similarly, patients with a normal cerebral performance score were more likely than those with abnormal scores to undergo ICD insertion (adjusted OR 12.52, 95% CI 1.74–92.12). Interpretation A minority of patients who survived cardiac arrest underwent ICD insertion. It is unclear whether this low usage rate reflects referral bias, selection bias by electrophysiologists, supply constraint or patient preference. PMID:15505267

  5. Trends in PICU Admission and Survival Rates in Children in Australia and New Zealand Following Cardiac Arrest. (United States)

    Straney, Lahn D; Schlapbach, Luregn J; Yong, Glenn; Bray, Janet E; Millar, Johnny; Slater, Anthony; Alexander, Janet; Finn, Judith


    To describe the temporal trends in rates of PICU admissions and mortality for out-of-hospital cardiac arrests and in-hospital cardiac arrests admitted to PICU over the last decade. Multicenter, retrospective analysis of prospectively collected binational data of the Australian and New Zealand Paediatric Intensive Care Registry. All nine specialist PICUs in Australia and New Zealand were included. All children admitted between 2003 and 2012 to PICU who were less than 16 years old at the time of admission. None. There were a total of 71,425 PICU admissions between 2003 and 2012. Overall, cardiac arrest accounted for 1.86% of all admissions (1,329 cases), including 677 cases of in-hospital cardiac arrest (51.0%) and 652 cases of out-of-hospital cardiac arrest (49.0%). Over the last decade, there has been a 29.6% increase in the odds of PICU survival for all pediatric admissions (odds ratio, 1.30; 95% CI, 1.09-1.54). By contrast, there was no significant improvement in the risk-adjusted odds of survival for out-of-hospital cardiac arrest admissions (odds ratio, 1.03; 95% CI, 0.50-2.10; p = 0.94) or in-hospital cardiac arrest admissions (odds ratio, 1.03; 95% CI, 0.54-1.98; p = 0.92). Despite improvements in overall outcomes in children admitted to Australian and New Zealand PICUs, survival of children admitted with out-of-hospital cardiac arrest or in-hospital cardiac arrest did not change significantly over the past decade.

  6. Self-Reported Arrests Among Indigenous Adolescents: a Longitudinal Analysis of Community, Family, and Individual Risk Factors. (United States)

    Sittner, Kelley J; Gentzler, Kari C


    North American indigenous (American Indian/Canadian First Nations) adolescents are overrepresented in the juvenile justice systems in the USA and Canada. One explanation advanced for disproportionate numbers of racial and ethnic minorities in the justice systems is the unequal distribution of risk factors across groups. The purpose of this study is to investigate the prevalence of and risk factors for first arrest within a population sample of indigenous adolescents. The data come from an 8-year longitudinal panel study of indigenous youth ( n = 641) from the northern Midwest and Canada, spanning ages 10 to 19 years. We used a discrete-time survival model to estimate the overall hazard of first arrest and change in the arrest hazard over time and included both time-invariant and time varying risk factors. The risk of arrest increased over time, although the largest increase occurred between waves 3 and 4, when the adolescents averaged 13.1 and 14.3 years, respectively. The youth had a 55 % probability of being arrested at least once by the end of the study. Of the time-invariant risk factors, exposure to violence, parent arrest, age, and income were associated with overall risk of first arrest. Three time-varying risk factors (alcohol use, marijuana use, and peer delinquency) were associated with changes in the risk of first arrest. Being arrested carries significant repercussions for young people, including involvement in the juvenile justice system as well as consequences into adulthood. Communities must go beyond programs that target problem behaviors because community, family, and peer factors are also important.

  7. Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. (United States)

    Ryvlin, Philippe; Nashef, Lina; Lhatoo, Samden D; Bateman, Lisa M; Bird, Jonathan; Bleasel, Andrew; Boon, Paul; Crespel, Arielle; Dworetzky, Barbara A; Høgenhaven, Hans; Lerche, Holger; Maillard, Louis; Malter, Michael P; Marchal, Cecile; Murthy, Jagarlapudi M K; Nitsche, Michael; Pataraia, Ekaterina; Rabben, Terje; Rheims, Sylvain; Sadzot, Bernard; Schulze-Bonhage, Andreas; Seyal, Masud; So, Elson L; Spitz, Mark; Szucs, Anna; Tan, Meng; Tao, James X; Tomson, Torbjörn


    Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in people with chronic refractory epilepsy. Very rarely, SUDEP occurs in epilepsy monitoring units, providing highly informative data for its still elusive pathophysiology. The MORTEMUS study expanded these data through comprehensive evaluation of cardiorespiratory arrests encountered in epilepsy monitoring units worldwide. Between Jan 1, 2008, and Dec 29, 2009, we did a systematic retrospective survey of epilepsy monitoring units located in Europe, Israel, Australia, and New Zealand, to retrieve data for all cardiorespiratory arrests recorded in these units and estimate their incidence. Epilepsy monitoring units from other regions were invited to report similar cases to further explore the mechanisms. An expert panel reviewed data, including video electroencephalogram (VEEG) and electrocardiogram material at the time of cardiorespiratory arrests whenever available. 147 (92%) of 160 units responded to the survey. 29 cardiorespiratory arrests, including 16 SUDEP (14 at night), nine near SUDEP, and four deaths from other causes, were reported. Cardiorespiratory data, available for ten cases of SUDEP, showed a consistent and previously unrecognised pattern whereby rapid breathing (18-50 breaths per min) developed after secondary generalised tonic-clonic seizure, followed within 3 min by transient or terminal cardiorespiratory dysfunction. Where transient, this dysfunction later recurred with terminal apnoea occurring within 11 min of the end of the seizure, followed by cardiac arrest. SUDEP incidence in adult epilepsy monitoring units was 5·1 (95% CI 2·6-9·2) per 1000 patient-years, with a risk of 1·2 (0·6-2·1) per 10,000 VEEG monitorings, probably aggravated by suboptimum supervision and possibly by antiepileptic drug withdrawal. SUDEP in epilepsy monitoring units primarily follows an early postictal, centrally mediated, severe alteration of respiratory and cardiac function induced by

  8. Results of crack-arrest tests on irradiated a 508 class 3 steel

    Energy Technology Data Exchange (ETDEWEB)

    Iskander, S.K.; Milella, P.P.; Pini, M.A.


    Ten crack-arrest toughness values for irradiated specimens of A 508 class 3 forging steel have been obtained. The tests were performed according to the American Society for Testing and Materials (ASTM) Standard Test Method for Determining Plane-Strain Crack-Arrest Fracture Toughness, K{sub la} of Ferritic Steels, E 1221-88. None of these values are strictly valid in all five ASTM E 1221-88 validity criteria. However, they are useful when compared to unirradiated crack-arrest specimen toughness values since they show the small (averaging approximately 10{degrees}C) shifts in the mean and lower-bound crack-arrest toughness curves. This confirms that a low copper content in ASTM A 508 class 3 forging material can be expected to result in small shifts of the transition toughness curve. The shifts due to neutron irradiation of the lower bound and mean toughness curves are approximately the same as the Charpy V-notch (CVN) 41-J temperature shift. The nine crack-arrest specimens were irradiated at temperatures varying from 243 to 280{degrees}C, and to a fluence varying from 1.7 to 2.7 x 10{sup 19} neutrons/cm{sup 2} (> 1 MeV). The test results were normalized to reference values that correspond to those of CVN specimens irradiated at 284{degrees}C to a fluence of 3.2 x 10{sup 19} neutrons/cm{sup 2} (> 1 MeV) in the same capsule as the crack-arrest specimens. This adjustment resulted in a shift to lower temperatures of all the data, and in particular moved two data points that appeared to lie close to or lower than the American Society of Mechanical Engineers K{sub la} curve to positions that seemed more reasonable with respect to the remaining data. A special fixture was designed, fabricated, and successfully used in the testing. For reasons explained in the text, special blocks to receive the Oak Ridge National Laboratory clip gage were designed, and greater-than-standard crack-mouth opening displacements measured were accounted for. 24 refs., 13 figs., 12 tabs.

  9. Locating AED Enabled Medical Drones to Enhance Cardiac Arrest Response Times. (United States)

    Pulver, Aaron; Wei, Ran; Mann, Clay


    Out-of-hospital cardiac arrest (OOHCA) is prevalent in the United States. Each year between 180,000 and 400,000 people die due to cardiac arrest. The automated external defibrillator (AED) has greatly enhanced survival rates for OOHCA. However, one of the important components of successful cardiac arrest treatment is emergency medical services (EMS) response time (i.e., the time from EMS "wheels rolling" until arrival at the OOHCA scene). Unmanned Aerial Vehicles (UAV) have regularly been used for remote sensing and aerial imagery collection, but there are new opportunities to use drones for medical emergencies. The purpose of this study is to develop a geographic approach to the placement of a network of medical drones, equipped with an automated external defibrillator, designed to minimize travel time to victims of out-of-hospital cardiac arrest. Our goal was to have one drone on scene within one minute for at least 90% of demand for AED shock therapy, while minimizing implementation costs. In our study, the current estimated travel times were evaluated in Salt Lake County using geographical information systems (GIS) and compared to the estimated travel times of a network of AED enabled medical drones. We employed a location model, the Maximum Coverage Location Problem (MCLP), to determine the best configuration of drones to increase service coverage within one minute. We found that, using traditional vehicles, only 4.3% of the demand can be reached (travel time) within one minute utilizing current EMS agency locations, while 96.4% of demand can be reached within five minutes using current EMS vehicles and facility locations. Analyses show that using existing EMS stations to launch drones resulted in 80.1% of cardiac arrest demand being reached within one minute Allowing new sites to launch drones resulted in 90.3% of demand being reached within one minute. Finally, using existing EMS and new sites resulted in 90.3% of demand being reached while greatly reducing

  10. Reduction of the visual impact of overhead transmission line systems through utilisation of line surge arresters as lightning protection

    DEFF Research Database (Denmark)

    Sørensen, Thomas Kjærsgaard; Holbøll, Joachim


    in line performance and lightning protection of the nearest substations requires thorough modelling of the new line including all electrical parameters necessary for performance evaluation under all conditions. In this paper, explicit use of line surge arresters as lightning protection on the line...... of the line and the required protection level in substations. The use of line surge arresters gives the possibility to decrease the height of towers thereby improving the visual impression of the overhead line transmission systems. However the usage of line surge arresters will, dependent upon line surge...

  11. Development of a theoretical guide for nursing care in cardiac arrest

    Directory of Open Access Journals (Sweden)

    Aliandra Bittencourt da Silva


    Full Text Available This study aimed to identify the knowledge on cardiorespiratory arrest among nurses in a hospital of Vale do Paraíba, São Paulo, Brazil, and develop a theoretical guide for care of this emergency. We prepared an instrument of data collection based on relevant literature and the 2010 AHA Guidelines for CPR, from August to October 2012. The sample consisted of 41 nurses who deliver care activities in various units of the hospital. The study showed that professional participants said they were able to act in cardiopulmonary resuscitation, however, there were limitations of knowledge about the theme. Given the above, we developed a theoretical guide for cardiac arrest care based on scientific literature and covering questions submitted by nurses.

  12. A descriptive analysis of public school educators arrested for sex offenses. (United States)

    Ratliff, Lindon; Watson, Joshua


    This study examined trends and patterns in public school teacher convictions in order to create a descriptive profile of teachers who have offended against their students. To accomplish this goal, the authors reviewed public records for demographic information as well as the history and frequency of teacher arrests and convictions in the southeastern United States from 2007 to 2011 and created an offender profile. Subsequent analyses were conducted to assess whether gender differences among sexual misconduct offenders existed in terms of the age of their alleged victim, the grade level in which they were employed at the time of arrest or indictment, and the manner by which their alleged crimes were revealed and charges were brought against them.

  13. Continuous versus Arrested Spreading of Biofilms at Solid-Gas Interfaces: The Role of Surface Forces (United States)

    Trinschek, Sarah; John, Karin; Lecuyer, Sigolène; Thiele, Uwe


    We introduce and analyze a model for osmotically spreading bacterial colonies at solid-air interfaces that includes wetting phenomena, i.e., surface forces. The model is based on a hydrodynamic description for liquid suspensions which is supplemented by bioactive processes. We show that surface forces determine whether a biofilm can expand laterally over a substrate and provide experimental evidence for the existence of a transition between continuous and arrested spreading for Bacillus subtilis biofilms. In the case of arrested spreading, the lateral expansion of the biofilm is confined, albeit the colony is biologically active. However, a small reduction in the surface tension of the biofilm is sufficient to induce spreading. The incorporation of surface forces into our hydrodynamic model allows us to capture this transition in biofilm spreading behavior.

  14. Engineering of Genetically Arrested Parasites (GAPs) For a Precision Malaria Vaccine. (United States)

    Kreutzfeld, Oriana; Müller, Katja; Matuschewski, Kai


    Continuous stage conversion and swift changes in the antigenic repertoire in response to acquired immunity are hallmarks of complex eukaryotic pathogens, including Plasmodium species, the causative agents of malaria. Efficient elimination of Plasmodium liver stages prior to blood infection is one of the most promising malaria vaccine strategies. Here, we describe different genetically arrested parasites (GAPs) that have been engineered in Plasmodium berghei, P. yoelii and P. falciparum and compare their vaccine potential. A better understanding of the immunological mechanisms of prime and boost by arrested sporozoites and experimental strategies to enhance vaccine efficacy by further engineering existing GAPs into a more immunogenic form hold promise for continuous improvements of GAP-based vaccines. A critical hurdle for vaccines that elicit long-lasting protection against malaria, such as GAPs, is safety and efficacy in vulnerable populations. Vaccine research should focus on solutions toward turning malaria into a vaccine-preventable disease, which would offer an exciting new path of malaria control.

  15. Determinants of occurrence and survival after sudden cardiac arrest-A European perspective

    DEFF Research Database (Denmark)

    Empana, Jean-Philippe; Blom, Marieke T; Bӧttiger, Bernd W


    AIMS: The ESCAPE-NET project ("European Sudden Cardiac Arrest network- towards Prevention, Education and New Effective Treatments") aims to study: (1) risk factors and mechanisms for the occurrence of sudden cardiac arrest (SCA) in the population, and (2) risk factors and treatment strategies...... for survival after SCA on a European scale. METHODS: This is an Horizon2020 funded program of the European Union, performed by a European public-private consortium of 16 partners across 10 EU countries. There are 11 deep-phenotyped SCA cohorts for the study of risk factors and treatment strategies for survival...... after SCA, and 5 deep-phenotyped observational prospective population cohorts for the study of risk factors for occurrence of SCA. Personalized risk scores for predicting SCA onset and for predicting survival after SCA will be derived and validated. RESULTS: The 11 clinical studies with SCA cases...

  16. [Diagnosis of essential thrombocythemia after myocardial infarction and cardiac arrest: A case report]. (United States)

    Cartigny, G; Faivre, V; Stamboul, K; Aulagne, J; Cottin, Y


    Acute coronary syndrome is now a well-known disease, with codified treatments. The main presentation is chest pain, but more and more cases are revealed by cardiorespiratory arrest thanks to pre-hospital care. And, depending on the evolution in such situations, cardiocirculatory support techniques like extracorporeal membrane oxygenation (ECMO) can be implemented. If the more common cause of SCA is atherosclerosis, consequence of the combination of one or more cardiovascular risk factors, there are rare aetiologies, which include myeloproliferative syndromes, in particular essential thrombocythemia. We describe the case of a 34-year-old man presenting with anterior ST-elevation myocardial infarction complicated by an initial cardiac arrest, whose aetiology is unknown essential thrombocythemia, and its therapeutic management requiring circulatory support by ECMO and IMPELLA(®) techniques. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. Microstructural evaluation of a varistor block utilized in high voltage surge arresters

    International Nuclear Information System (INIS)

    Andrade, J.M. de; Dias, R.; Furtado, J.G. de M.; Assuncao, F.C.R.


    Varistor is a semiconductor ceramic device characterized to have a high non-linear electrical resistance, it is used as active element of surge arresters with purpose of protecting of electro-electronics systems. Its properties are directly dependents of chemical composition and microstructural characteristics, such as grain size, porosity, twins and phases distribution. This work has the objective to characterize microstructurally a commercial varistor block of ZnO used in high voltage surge arrest and from this characterization to infer aspects about of its electrical macroscopic performance. DRX and SEM-EDS were used for microstructural analysis. The microstructural evaluation allows pointing the critical points of microstructure and, suggest relevant aspects to the improvement of commercial varistor microstructure, optimizing the electrothermal behavior of the device. (author)

  18. Heavy-Section Steel Technology Program: Recent developments in crack initiation and arrest research

    International Nuclear Information System (INIS)

    Pennell, W.E.


    Technology for the analysis of crack initiation and arrest is central to the reactor pressure vessel fracture-margin-assessment process. Regulatory procedures for nuclear plants utilize this technology to assure the retention of adequate fracture-prevention margins throughout the plant operating license period. As nuclear plants age and regulatory procedures dictate that fracture-margin assessments be performed, interest in the fracture-mechanics technology incorporated into those procedures has heightened. This has led to proposals from a number of sources for development and refinement of the underlying crack-initiation and arrest-analysis technology. This paper presents an overview of ongoing Heavy-Section Steel Technology (HSST) Program research aimed at refining the fracture toughness data used in the analysis of fracture margins under pressurized-thermal-shock loading conditions. 33 refs., 13 figs

  19. Proteomic analysis of arginine methylation sites in human cells reveals dynamic regulation during transcriptional arrest

    DEFF Research Database (Denmark)

    Sylvestersen, Kathrine B; Horn, Heiko; Jungmichel, Stephanie


    mono-methylation (MMA) sites. We thereby identify 1,027 site-specific MMA sites on 494 human proteins, discovering numerous novel mono-methylation targets and confirming the majority of currently known MMA substrates. Nuclear RNA-binding proteins involved in RNA processing, RNA localization......, transcription, and chromatin remodeling are predominantly found modified with MMA. Despite this, MMA sites prominently are located outside RNA-binding domains as compared to the proteome-wide distribution of arginine residues. Quantification of arginine methylation in cells treated with Actinomycin D uncovers...... strong site-specific regulation of MMA sites during transcriptional arrest. Interestingly, several MMA sites are down-regulated after a few hours of transcriptional arrest. In contrast, the corresponding di-methylation or protein expression level is not altered in expression, confirming that MMA sites...

  20. European Resuscitation Council (ERC) - the Network to fight against cardiac arrest in Europe. (United States)

    Raffay, Violetta


    The ideas of collaboration and formation of scientific societies and registries for cardiac arrest were developed in the 18th century. The European Resuscitation Council (ERC) was formed in 1990. Nowadays, the ERC network consists of 30 National Resuscitation Councils (NRCs), which have an obligation to ensure that effective resuscitation services are provided and to promote education, training, and research in all aspects of resuscitation science. The central role of NRCs in decreasing the incidence of cardiac arrest may be highlighted and enhanced by the incorporation and implementation of the following suggestions. NRCs should emphasize and actively participate in acute care training of healthcare professionals and of lay rescuers. Implementation of current resuscitation guidelines should be a priority of each NRC and identification of the weakest link in the chain of survival should be a priority. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Post-cardiac arrest level of free-plasma DNA and DNA-histone complexes

    DEFF Research Database (Denmark)

    Jeppesen, A N; Hvas, A-M; Grejs, A M


    Background Plasma DNA-histone complexes and total free-plasma DNA have the potential to quantify the ischaemia-reperfusion damages occurring after cardiac arrest. Furthermore, DNA-histone complexes may have the potential of being a target for future treatment. The aim was to examine if plasma DNA-histone...... after 22, 46 and 70 h. Samples for DNA-histone complexes were quantified by Cell Death Detection ELISAplus. The total free-plasma DNA analyses were quantified with qPCR by analysing the Beta-2 microglobulin gene. The control group comprised 40 healthy individuals. Results We found no difference...... in the level of DNA-histone complexes between the 22-h sample and healthy individuals (P = 0.10). In the 46-h sample, there was an increased level of DNA-histone complexes in non-survivors compared with survivors 30 days after the cardiac arrest (P

  2. Prp19 Arrests Cell Cycle via Cdc5L in Hepatocellular Carcinoma Cells

    Directory of Open Access Journals (Sweden)

    Renzheng Huang


    Full Text Available Pre-mRNA processing factor 19 (Prp19 is involved in many cellular events including pre-mRNA processing and DNA damage response. Recently, it has been identified as a candidate oncogene in hepatocellular carcinoma (HCC. However, the role of Prp19 in tumor biology is still elusive. Here, we reported that Prp19 arrested cell cycle in HCC cells via regulating G2/M transition. Mechanistic insights revealed that silencing Prp19 inhibited the expression of cell division cycle 5-like (Cdc5L via repressing the translation of Cdc5L mRNA and facilitating lysosome-mediated degradation of Cdc5L in HCC cells. Furthermore, we found that silencing Prp19 induced cell cycle arrest could be partially resumed by overexpressing Cdc5L. This work implied that Prp19 participated in mitotic progression and thus could be a promising therapeutic target of HCC.

  3. Cardiac Arrest Following Drug Abuse with Intravenous Tapentadol: Case Report and Literature Review. (United States)

    Khaja, Misbahuddin; Lominadze, George; Millerman, Konstantin


    BACKGROUND Tapentadol is a centrally acting opioid analgesic, with a dual mode of action, as a norepinephrine reuptake inhibitor and an agonist of the μ-opioid receptor (MOR). Tapentadol is used for the management of musculoskeletal pain, and neuropathic pain associated with diabetic peripheral neuropathy. CASE REPORT A 32-year-old woman attended hospital for evaluation of an intractable headache. Computed tomography and magnetic resonance imaging of the brain were negative. She was found unresponsive in the bathroom on the day following hospital admission, and despite resuscitative measures, the patient died following cardiac arrest. Autopsy toxicology revealed significantly elevated levels of tapentadol, and bedside evidence suggested that the patient had self-administered this medication intravenously before her death. CONCLUSIONS We report a rare adverse effect of tapentadol causing respiratory depression leading to cardiac arrest. Medical examiners and forensic toxicologists should be aware of the toxicity of this novel opiate drug.

  4. Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Glover, Guy W; Thomas, Richard M; Vamvakas, George


    BACKGROUND: Targeted temperature management is recommended after out-of-hospital cardiac arrest and may be achieved using a variety of cooling devices. This study was conducted to explore the performance and outcomes for intravascular versus surface devices for targeted temperature management after...... out-of-hospital cardiac arrest. METHOD: A retrospective analysis of data from the Targeted Temperature Management trial. N = 934. A total of 240 patients (26%) managed with intravascular versus 694 (74%) with surface devices. Devices were assessed for speed and precision during the induction......, maintenance and rewarming phases in addition to adverse events. All-cause mortality, as well as a composite of poor neurological function or death, as evaluated by the Cerebral Performance Category and modified Rankin scale were analysed. RESULTS: For patients managed at 33 °C there was no difference between...

  5. Recurrent syncope and cardiac arrest in a patient with systemic light chain amyloidosis treated with bortezomib

    Directory of Open Access Journals (Sweden)

    Navin Jaipaul


    Full Text Available About 10-15% of patients with multiple myeloma develop light chain (AL amyloidosis. AL amyloidosis is a systemic disease that may involve multiple organs, often including the heart. It may present clinically with bradyarrhythmia and syncope. The proteasome inhibitor bortezomib has been used with clinical efficacy in treating patients with AL amyloidosis but also implicated as a possible cause of cardiomyocyte injury. We report a case of a 48-year-old man with AL amyloidosis and increased frequency of syncope and cardiac arrest after starting bortezomib. The biologic and clinical plausibility of a heightened risk for cardiac arrest in patients with cardiac AL amyloidosis and history of syncope being treated with bortezomib is a possibility that is not well documented in the medical literature and warrants further investigation.

  6. Survival after Out-of-Hospital Cardiac Arrest in Nursing Homes

    DEFF Research Database (Denmark)

    Pape, Marianne; Rajan, Shahzleen; Hansen, Steen Møller


    BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home...... residents. METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival....... Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately. RESULTS: Of 26,999 OCHAs, 2516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1...

  7. A Link between Meiotic Prophase Progression and CrossoverControl

    Energy Technology Data Exchange (ETDEWEB)

    Carlton, Peter M.; Farruggio, Alfonso P.; Dernburg, Abby F.


    During meiosis, most organisms ensure that homologous chromosomes undergo at least one exchange of DNA, or crossover, to link chromosomes together and accomplish proper segregation. How each chromosome receives a minimum of one crossover is unknown. During early meiosis in Caenorhabditis elegans and many other species, chromosomes adopt a polarized organization within the nucleus, which normally disappears upon completion of homolog synapsis. Mutations that impair synapsis even between a single pair of chromosomes in C. elegans delay this nuclear reorganization. We quantified this delay by developing a classification scheme for discrete stages of meiosis. Immunofluorescence localization of RAD-51 protein revealed that delayed meiotic cells also contained persistent recombination intermediates. Through genetic analysis, we found that this cytological delay in meiotic progression requires double-strand breaks and the function of the crossover-promoting heteroduplex HIM-14 (Msh4) and MSH-5. Failure of X chromosome synapsis also resulted in impaired crossover control on autosomes, which may result from greater numbers and persistence of recombination intermediates in the delayed nuclei. We conclude that maturation of recombination events on chromosomes promotes meiotic progression, and is coupled to the regulation of crossover number and placement. Our results have broad implications for the interpretation of meiotic mutants, as we have shown that asynapsis of a single chromosome pair can exert global effects on meiotic progression and recombination frequency.

  8. From the school yard to the squad car: school discipline, truancy, and arrest. (United States)

    Monahan, Kathryn C; VanDerhei, Susan; Bechtold, Jordan; Cauffman, Elizabeth


    Since the 1990's, implementation of zero tolerance policies in schools has led to increased use of school suspension and expulsion as disciplinary techniques for students with varying degrees of infractions. An unintended consequence of zero tolerance policies is that school suspension or expulsion may increase risk for contact with the juvenile justice system. In the present study, we test how forced absence from school via suspension or expulsion and chosen absence from school (truancy) are associated with the likelihood of being arrested. Using month-level data from 6,636 months from a longitudinal study of delinquent adolescents (N = 1,354; 13.5 % female; 41.5 % Black, 33.5 % Hispanic-American, 20.2 % White), we compare the likelihood of being arrested, within individuals, for months when youth were and were not suspended or expelled from school and for months when youth were and were not truant. Finally, we test if these associations were moderated by stable demographic characteristics (sex, race, age, history of problem behaviors) and time-varying contextual factors (peer delinquency, parental monitoring, and commitment to school). Being suspended or expelled from school increased the likelihood of arrest in that same month and this effect was stronger among youth who did not have a history of behavior problems and when youth associated with less delinquent peers. Truancy independently contributed to the likelihood of arrest, but this association was explained by differences in parental monitoring and school commitment. Thus, school disciplinary action places youth at risk for involvement in the juvenile justice system and this may be especially true for less risky youth.

  9. Cardiac arrest during treatment of Pneumocystis carinii pneumonia with intravenous pentamidine isethionate

    DEFF Research Database (Denmark)

    Balslev, U; Berild, D; Nielsen, T L


    A 27-year-old man, HIV-positive for 4 years, developed ventricular fibrillation and cardiac arrest during treatment of Pneumocystis carinii pneumonia with intravenous pentamidine isethionate. The dosage was 4 mg/kg/day for 18 days. Nephrotoxicity occurred and raised serum potassium. The plasma...... concentration of pentamidine was 580 nmol/l. Careful monitoring of renal and cardiac functions is recommended during intravenous therapy with pentamidine isethionate....

  10. Bocavirus Infection Induces Mitochondrion-Mediated Apoptosis and Cell Cycle Arrest at G2/M Phase▿


    Chen, Aaron Yun; Luo, Yong; Cheng, Fang; Sun, Yuning; Qiu, Jianming


    Bocavirus is a newly classified genus of the family Parvovirinae. Infection with Bocavirus minute virus of canines (MVC) produces a strong cytopathic effect in permissive Walter Reed/3873D (WRD) canine cells. We have systematically characterized the MVC infection-produced cytopathic effect in WRD cells, namely, the cell death and cell cycle arrest, and carefully examined how MVC infection induces the cytopathic effect. We found that MVC infection induces an apoptotic cell death characterized ...

  11. Upregulation of eIF5B controls cell-cycle arrest and specific developmental stages


    Lee, Sooncheol; Truesdell, Samuel S.; Bukhari, Syed I. A.; Lee, Ju Huck; LeTonqueze, Olivier; Vasudevan, Shobha


    This study uncovers a critical role for a general translation factor in specific developmental stages, including immature oocytes and ES cells, and during growth-factor deprivation of mammalian cells, which induces the transition to cell-cycle arrest. These conditions alter and decrease general translation yet maintain ongoing translation. We reveal upregulation of the eukaryotic translation factor 5B (eIF5B), which becomes essential for general translation, specifically in these conditions. ...

  12. Arrested α-hydride migration activates a phosphido ligand for C–H insertion

    Energy Technology Data Exchange (ETDEWEB)

    Hickey, Anne K. [Indiana Univ., Bloomington, IN (United States); Muñoz, Salvador B. [Indiana Univ., Bloomington, IN (United States); Lutz, Sean A. [Indiana Univ., Bloomington, IN (United States); Pink, Maren [Indiana Univ., Bloomington, IN (United States); Chen, Chun-Hsing [Indiana Univ., Bloomington, IN (United States); Smith, Jeremy M. [Indiana Univ., Bloomington, IN (United States)


    Bulky tris(carbene)borate ligands provide access to high spin iron(II) phosphido complexes. The complex PhB(MesIm)3FeP(H)Ph is thermally unstable, and we observed [PPh] group insertion into a C–H bond of the supporting ligand. An arrested α-hydride migration mechanism suggests increased nucleophilicity of the phosphorus atom facilitates [PPh] group transfer reactivity.

  13. Occlusive ascending aorta and arch atheroma treated with deep hypothermic circulatory arrest and thromboendarterectomy.

    LENUS (Irish Health Repository)

    O' Sullivan, Katie E


    We describe an uncommon presentation of severely advanced aortic atherosclerosis in a 48-year old man with a history of hypertension and heavy smoking. Initial presentation with upper limb ischaemia led to the diagnosis of an aortic arch atheroma occluding 90% of the aortic lumen, managed with deep hypothermic circulatory arrest and aortic thromboendarterectomy. To our knowledge, this is the first reported case of atherosclerotic plaque resulting in aortic occlusion and requiring emergent operative intervention.

  14. Antidepressant Use and Risk of Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Weeke, P; Jensen, Aksel Karl Georg; Folke, F


    being the most frequently used type of antidepressant (50.8%). Tricyclic antidepressants (TCAs; odds ratio (OR) = 1.69, confidence interval (CI): 1.14-2.50) and selective serotonin reuptake inhibitors (SSRIs; OR = 1.21, CI: 1.00-1.47) were both associated with comparable increases in risk of OHCA.......17-12.2). An association between cardiac arrest and antidepressant use could be documented in both the SSRI and TCA classes of drugs....

  15. Demographics, Bystander CPR, and AED Use in Out-of-Hospital Pediatric Arrests (United States)

    Johnson, M. Austin; Grahan, Brian J. H.; Haukoos, Jason S.; McNally, Bryan; Campbell, Robert; Sasson, Comilla; Slattery, David E.


    Background In 2005 the American Heart Association released guidelines calling for routine use of automated external defibrillators during pediatric out-of-hospital arrest. The goal of this study was to determine if these guidelines are used during resuscitations. Methods We conducted a secondary analysis of prospectively collected data from 29 U.S. cities that participate in the Cardiac Arrest Registry to Enhance Survival (CARES). Patients were included if they were older than 1 year of age and had a documented resuscitation attempt from October 1, 2005 through December 31, 2009 from an arrest presumed to be cardiac in nature. Hierarchical multivariable logistic regression analysis was used to estimate the associations between age, demographic factors, and AED use. Results 129 patients were 1–8 years of age (younger children), 88 patients were 9–17 years of age (older children), and 19,338 patients were ≥18 years of age (adults). When compared to adults, younger children were less likely to be found in a shockable rhythm (young children 11.6%, adults 23.7%) and were less likely to have an AED used (young children 16.3%, adults 28.3%). Older children had a similar prevalence of shockable rhythms as adults (31.8%) and AED use (20.5%). A multivariable analysis demonstrated that, when compared to adults, younger children had decreased odds of having an AED used (OR 0.42, 95% CI 0.26–0.69), but there was no difference in AED use among older children and adults. Conclusions Young children suffering from presumed out-of-hospital cardiac arrests are less likely to have a shockable rhythm when compared to adults, and are less likely to have an AED used during resuscitation. PMID:24681302

  16. Prolonged mitotic arrest induced by Wee1 inhibition sensitizes breast cancer cells to paclitaxel (United States)

    Lewis, Cody W.; Jin, Zhigang; Macdonald, Dawn; Wei, Wenya; Qian, Xu Jing; Choi, Won Shik; He, Ruicen; Sun, Xuejun; Chan, Gordon


    Wee1 kinase is a crucial negative regulator of Cdk1/cyclin B1 activity and is required for normal entry into and exit from mitosis. Wee1 activity can be chemically inhibited by the small molecule MK-1775, which is currently being tested in phase I/II clinical trials in combination with other anti-cancer drugs. MK-1775 promotes cancer cells to bypass the cell-cycle checkpoints and prematurely enter mitosis. In our study, we show premature mitotic cells that arise from MK-1775 treatment exhibited centromere fragmentation, a morphological feature of mitotic catastrophe that is characterized by centromeres and kinetochore proteins that co-cluster away from the condensed chromosomes. In addition to stimulating early mitotic entry, MK-1775 treatment also delayed mitotic exit. Specifically, cells treated with MK-1775 following release from G1/S or prometaphase arrested in mitosis. MK-1775 induced arrest occurred at metaphase and thus, cells required 12 times longer to transition into anaphase compared to controls. Consistent with an arrest in mitosis, MK-1775 treated prometaphase cells maintained high cyclin B1 and low phospho-tyrosine 15 Cdk1. Importantly, MK-1775 induced mitotic arrest resulted in cell death regardless the of cell-cycle phase prior to treatment suggesting that Wee1 inhibitors are also anti-mitotic agents. We found that paclitaxel enhances MK-1775 mediated cell killing. HeLa and different breast cancer cell lines (T-47D, MCF7, MDA-MB-468 and MDA-MB-231) treated with different concentrations of MK-1775 and low dose paclitaxel exhibited reduced cell survival compared to mono-treatments. Our data highlight a new potential strategy for enhancing MK-1775 mediated cell killing in breast cancer cells. PMID:29088738

  17. Hemodynamic–directed cardiopulmonary resuscitation during in–hospital cardiac arrest*


    Sutton, Robert M.; Friess, Stuart H.; Maltese, Matthew R.; Naim, Maryam Y.; Bratinov, George; Weiland, Theodore R.; Garuccio, Mia; Bhalala, Utpal; Nadkarni, Vinay M.; Becker, Lance B.; Berg, Robert A.


    Cardiopulmonary resuscitation (CPR) guidelines assume that cardiac arrest victims can be treated with a uniform chest compression (CC) depth and a standardized interval administration of vasopressor drugs. This non-personalized approach does not incorporate a patient’s individualized response into ongoing resuscitative efforts. In previously reported porcine models of hypoxic and normoxic ventricular fibrillation (VF), a hemodynamic-directed resuscitation improved short-term survival compared...

  18. [Sudden cardiorespiratory arrest in adults with acute epiglottitis. Report of 2 cases]. (United States)

    Pino Rivero, V; Pantoja Hernandez, C G; González Palomino, A; Mora Santos, M E; Pardo Romero, G; Blasco Huelva, A


    We report two adult cases of sudden cardiorespiratory arrest because an acute epiglottitis that ocurred in our hospital. Although it is an uncommon pathology nowdays with good prognosis generally, we try to call the attention about this complication which can happen of unforseeable way even in previous absence of respiratory obstruction. One of the patients required coniotomy in ICU due to impossibility of orotracheal intubation (OI) and the other died in spite of an urgent performance.

  19. [Is high-dose epinephrine justified in cardiorespiratory arrest in children?]. (United States)

    Rodríguez Núñez, A; García, C; López-Herce Cid, J


    To evaluate the impact on survival of intravenous or intraosseous high-dose epinephrine compared with standard doses in children with cardiorespiratory arrest. We performed a multicenter, prospective study. Cardiopulmonary resuscitation data from 283 children was collected following international guidelines (Utstein style) over 18 months. In a secondary analysis we studied survival in 92 children who were treated with intravenous or intraosseous epinephrine. One or more conventional doses of epinephrine (0.01 mg/kg) were administered in 12 patients and a first conventional dose followed by one or more high doses (0.1 mg/kg) were administered in 80 patients. The age and weight of children in the conventional-dose group were higher than those in the high-dose group (97.1 +/- 70.5 months vs 29.9 +/- 36.9 months, p = 0.03 and 24.7 +/- 20.8 kg vs 11.9 +/- 8.9 kg, p = 0.037, respectively). The number of doses administered in the conventional-dose group was lower than that in the high-dose group (4 +/- 4 vs 5.4 +/- 3.4, p = 0.01). No significant differences were observed between the two groups in type of arrest, site of arrest, initial electrocardiographic rhythm, response to resuscitation attempts with return of spontaneous circulation, total resuscitation time, neurological status at the end of the episode and survival to hospital discharge and at 1-year of follow-up. Although the present study has considerable limitations, the results suggest that high doses of epinephrine do not improve survival in cardiorespiratory arrest in children.

  20. Women have worse cognitive, functional, and psychiatric outcomes at hospital discharge after cardiac arrest. (United States)

    Agarwal, Sachin; Presciutti, Alex; Verma, Jayati; Pavol, Marykay A; Anbarasan, Deepti; Brodie, Daniel; Rabbani, Leroy E; Roh, David J; Park, Soojin; Claassen, Jan; Stern, Yaakov


    To examine gender differences among cardiac arrest (CA) survivors' cognitive, functional, and psychiatric outcomes at discharge. This is a prospective, observational cohort of 187 CA patients admitted to Columbia University Medical Center, considered for Targeted Temperature Management (TTM), and survived to hospital discharge between September 2015 and July 2017. Patients with sufficient mental status at hospital discharge to engage in the Repeatable Battery for Neuropsychological Status (RBANS), Modified Lawton Physical Self-Maintenance Scale (M-PSMS), Cerebral Performance Category Scale (CPC), Center for Epidemiological Studies Depression Scale (CES-D), and Post-Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) were included. Fisher's exact, Wilcoxon Rank Sum, and regression analysis were utilized. 80 patients (38% women, 44% white, mean age 53 ± 17 years) were included. No significant gender differences were found for age, race, Charlson Comorbidity Index, premorbid CPC or psychiatric diagnoses, arrest related variables, discharge CPC, or PCL-C scores. Women had significantly worse RBANS (64.9 vs 74.8, p = .01), M-PSMS (13.6 vs 10.6, p = .02), and CES-D (22.8 vs 14.3, p = .02) scores. These significant differences were maintained in multivariate models after adjusting for age, initial rhythm, time to return of spontaneous circulation, and TTM. Women have worse cognitive, functional, and psychiatric outcomes at hospital discharge after cardiac arrest than men. Identifying factors contributing to these differences is of great importance in cardiac arrest outcomes research. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Use of the novel hemostatic textile Stasilon? to arrest refractory retroperitoneal hemorrhage: a case report


    Rich, Preston B; Douillet, Christelle; Buchholz, Valorie; Overby, David W; Jones, Samuel W; Cairns, Bruce A


    Abstract Introduction Stasilon® is a novel hemostatic woven textile composed of allergen-free fibers of continuous filament fiberglass and bamboo yarn. The development of this product resulted from controlled in vitro thrombogenic analysis of an array of potentially hemostatic textile materials and it has been cleared for both external and internal use by the United States Food and Drug Administration for the arrest of hemorrhage. The goal of the study was to assess the hemostatic and adhesiv...

  2. On the epidemiology of violent juvenile crime in America: a total arrest-referenced approach. (United States)

    Pellegrini, R J; Roundtree, T; Camagna, T F; Queirolo, S S


    The catalyst for this study was a widely publicized U.S. government-sponsored report forecasting alarming increases in violent juvenile crime. Working from data for the entire United States given in annual FBI Uniform Crime Reports, the study presented a descriptive statistical, historical profile of violent juvenile crime in America based on the percentage of all arrests for criminal homicide, forcible rape, robbery, and aggravated assault attributable to juveniles, 1941-1995. Markedly different patterns resulted from focusing on rates and rates of change calculated for 1-, 5-, and 10-yr. periods. Thus, for example, the most recent 5-yr. trend for criminal homicide indicated an average annual increase of 7.81% in the incidence of arrests attributable to juveniles, with a corresponding projected increase of 117% from 1995 to 2010. An average annual rate increase of 5.13% was indicated over the most recent 10-yr. period, leading to a predicted increase of 77% in 2010 as compared to 1995. By sharp contrast, focusing on the 15.3% rate increase which occurred in the most recent single year led to the expectation that juvenile arrests will account for 229% more of this nation's criminal homicide arrests in 2015 than was the case in 1995. In every case, widely discrepant, 15-yr. projection differences such as those noted above, are magnified considerably if we assume validity of U.S. census estimates concerning increases in the size of America's juvenile population over the time period considered. Results of the study are taken to underscore the importance of qualifying archival data-based inferences about violent juvenile crime, in terms of the specific measure(s) used and time-frame context(s) of the unit(s) of analysis.

  3. High-dose irradiation induces cell cycle arrest, apoptosis, and developmental defects during Drosophila oogenesis. (United States)

    Shim, Hee Jin; Lee, Eun-Mi; Nguyen, Long Duy; Shim, Jaekyung; Song, Young-Han


    Ionizing radiation (IR) treatment induces a DNA damage response, including cell cycle arrest, DNA repair, and apoptosis in metazoan somatic cells. Because little has been reported in germline cells, we performed a temporal analysis of the DNA damage response utilizing Drosophila oogenesis as a model system. Oogenesis in the adult Drosophila female begins with the generation of 16-cell cyst by four mitotic divisions of a cystoblast derived from the germline stem cells. We found that high-dose irradiation induced S and G2 arrests in these mitotically dividing germline cells in a grp/Chk1- and mnk/Chk2-dependent manner. However, the upstream kinase mei-41, Drosophila ATR ortholog, was required for the S-phase checkpoint but not for the G2 arrest. As in somatic cells, mnk/Chk2 and dp53 were required for the major cell death observed in early oogenesis when oocyte selection and meiotic recombination occurs. Similar to the unscheduled DNA double-strand breaks (DSBs) generated from defective repair during meiotic recombination, IR-induced DSBs produced developmental defects affecting the spherical morphology of meiotic chromosomes and dorsal-ventral patterning. Moreover, various morphological abnormalities in the ovary were detected after irradiation. Most of the IR-induced defects observed in oogenesis were reversible and were restored between 24 and 96 h after irradiation. These defects in oogenesis severely reduced daily egg production and the hatch rate of the embryos of irradiated female. In summary, irradiated germline cells induced DSBs, cell cycle arrest, apoptosis, and developmental defects resulting in reduction of egg production and defective embryogenesis.

  4. An Exploratory Study of Functional Status in Post Cardiac Arrest Survivors Discharged To Home (United States)


    Bangerter, Schuppel and Planta (2002) reporting on the quality of life in long-term survivors of out-of-hospital arrest, found that 49 out of the 50...random samplings of the population in both the United States and the United Kingdom . All reliability estimates exceeded accepted standards for measure...disease processes, social conditions, and random samplings of the population in both the United States and the United Kingdom . All reliability

  5. Characteristics and outcomes of young adults who suffered an out-of-hospital cardiac arrest (OHCA). (United States)

    Chia, Michael Yih-Chong; Lu, Qing Shu; Rahman, Nik Hisamuddin; Doctor, Nausheen Edwin; Nishiuchi, Tatsuya; Leong, Benjamin Sieu-Hon; Tham, Lai Peng; Goh, E-Shaun; Tiah, Ling; Monsomboon, Apichaya; Ong, Marcus Eng Hock


    There is paucity of data examining the incidence and outcomes of young OHCA adults. The aim of this study is to determine the outcomes and characteristics of young adults who suffered an OHCA and identify factors that are associated with favourable neurologic outcomes. All EMS-attended OHCA adults between the ages of 16 and 35 years in the Pan-Asian Resuscitation Outcomes Study (PAROS) registry were analysed. The primary outcome was favourable neurologic outcome (Cerebral Performance Category 1 or 2) at hospital discharge or at 30th day post OHCA if not discharged. Regression analysis was performed to identify factors associated with favourable neurologic outcomes. 66,780 OHCAs were collected between January 2009 and December 2013; 3244 young OHCAs had resuscitation attempted by emergency medical services (EMS). 56.8% of patients had unwitnessed arrest; 47.9% were of traumatic etiology. 17.2% of patients (95% CI: 15.9-18.5%) had return of spontaneous circulation; 7.8% (95% CI: 6.9-8.8%) survived to one month; 4.6% (95% CI: 4.0-5.4%) survived with favourable neurologic outcomes. Factors associated with favourable neurologic outcomes include witnessed arrest (adjusted RR=2.42, p-valueyoung adults are not uncommon. Traumatic OHCA, occurring most frequently in young adults had dismal prognosis. First arrest rhythms of VF/VT/unknown shockable rhythm, cardiac etiology, bystander-witnessed arrest, and bystander CPR were associated with favourable neurological outcomes. The results of the study would be useful for planning preventive and interventional strategies, improving EMS, and guiding future research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. National Institutes of Health-Funded Cardiac Arrest Research: A 10-Year Trend Analysis. (United States)

    Coute, Ryan A; Panchal, Ashish R; Mader, Timothy J; Neumar, Robert W


    Cardiac arrest (CA) is a leading cause of death in the United States, claiming over 450 000 lives annually. Improving survival depends on the ability to conduct CA research and on the translation and implementation of research findings into practice. Our objective was to provide a descriptive analysis of annual National Institutes of Health (NIH) funding for CA research over the past decade. A search within NIH RePORTER for the years 2007 to 2016 was performed using the terms: "cardiac arrest" or "cardiopulmonary resuscitation" or "heart arrest" or "circulatory arrest" or "pulseless electrical activity" or "ventricular fibrillation" or "resuscitation." Grants were reviewed and categorized as CA research (yes/no) using predefined criteria. The annual NIH funding for CA research, number of individual grants, and principal investigators were tabulated. The total NIH investment in CA research for 2015 was calculated and compared to those for other leading causes of death within the United States. Interrater reliability among 3 independent reviewers for fiscal year 2015 was assessed using Fleiss κ. The search yielded 2763 NIH-funded grants, of which 745 (27.0%) were classified as CA research (κ=0.86 [95%CI 0.80-0.93]). Total inflation-adjusted NIH funding for CA research was $35.4 million in 2007, peaked at $76.7 million in 2010, and has decreased to $28.5 million in 2016. Per annual death, NIH invests ≈$2200 for stroke, ≈$2100 for heart disease, and ≈$91 for CA. This analysis demonstrates that the annual NIH investment in CA research is low relative to other leading causes of death in the United States and has declined over the past decade. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  7. Prolyl oligopeptidase inhibition-induced growth arrest of human gastric cancer cells

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Kanayo [Laboratory of Cell Biology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094 (Japan); Sakaguchi, Minoru, E-mail: [Laboratory of Cell Biology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094 (Japan); Tanaka, Satoshi [Laboratory of Cell Biology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094 (Japan); Yoshimoto, Tadashi [Department of Life Science, Setsunan University, 17-8 Ikeda-Nakamachi, Neyagawa, Osaka 572-8508 (Japan); Takaoka, Masanori [Laboratory of Cell Biology, Osaka University of Pharmaceutical Sciences, 4-20-1 Nasahara, Takatsuki, Osaka 569-1094 (Japan)


    Highlights: •We examined the effects of prolyl oligopeptidase (POP) inhibition on p53 null gastric cancer cell growth. •POP inhibition-induced cell growth suppression was associated with an increase in a quiescent G{sub 0} state. •POP might regulate the exit from and/or reentry into the cell cycle. -- Abstract: Prolyl oligopeptidase (POP) is a serine endopeptidase that hydrolyzes post-proline peptide bonds in peptides that are <30 amino acids in length. We recently reported that POP inhibition suppressed the growth of human neuroblastoma cells. The growth suppression was associated with pronounced G{sub 0}/G{sub 1} cell cycle arrest and increased levels of the CDK inhibitor p27{sup kip1} and the tumor suppressor p53. In this study, we investigated the mechanism of POP inhibition-induced cell growth arrest using a human gastric cancer cell line, KATO III cells, which had a p53 gene deletion. POP specific inhibitors, 3-((4-[2-(E)-styrylphenoxy]butanoyl)-L-4-hydroxyprolyl)-thiazolidine (SUAM-14746) and benzyloxycarbonyl-thioprolyl-thioprolinal, or RNAi-mediated POP knockdown inhibited the growth of KATO III cells irrespective of their p53 status. SUAM-14746-induced growth inhibition was associated with G{sub 0}/G{sub 1} cell cycle phase arrest and increased levels of p27{sup kip1} in the nuclei and the pRb2/p130 protein expression. Moreover, SUAM-14746-mediated cell cycle arrest of KATO III cells was associated with an increase in the quiescent G{sub 0} state, defined by low level staining for the proliferation marker, Ki-67. These results indicate that POP may be a positive regulator of cell cycle progression by regulating the exit from and/or reentry into the cell cycle by KATO III cells.

  8. Prolonged Mechanical Ventilation Induces Cell Cycle Arrest in Newborn Rat Lung (United States)

    Kroon, Andreas A.; Wang, Jinxia; Kavanagh, Brian; Huang, Zhen; Kuliszewski, Maciej; van Goudoever, Johannes B.; Post, Martin


    Rationale The molecular mechanism(s) by which mechanical ventilation disrupts alveolar development, a hallmark of bronchopulmonary dysplasia, is unknown. Objective To determine the effect of 24 h of mechanical ventilation on lung cell cycle regulators, cell proliferation and alveolar formation in newborn rats. Methods Seven-day old rats were ventilated with room air for 8, 12 and 24 h using relatively moderate tidal volumes (8.5−1). Measurement and Main Results Ventilation for 24 h (h) decreased the number of elastin-positive secondary crests and increased the mean linear intercept, indicating arrest of alveolar development. Proliferation (assessed by BrdU incorporation) was halved after 12 h of ventilation and completely arrested after 24 h. Cyclin D1 and E1 mRNA and protein levels were decreased after 8–24 h of ventilation, while that of p27Kip1 was significantly increased. Mechanical ventilation for 24 h also increased levels of p57Kip2, decreased that of p16INK4a, while the levels of p21Waf/Cip1 and p15INK4b were unchanged. Increased p27Kip1 expression coincided with reduced phosphorylation of p27Kip1 at Thr157, Thr187 and Thr198 (pventilated with high tidal volume (40−1) and when fetal lung epithelial cells were subjected to a continuous (17% elongation) cyclic stretch. Conclusion This is the first demonstration that prolonged (24 h) of mechanical ventilation causes cell cycle arrest in newborn rat lungs; the arrest occurs in G1 and is caused by increased expression and nuclear localization of Cdk inhibitor proteins (p27Kip1, p57Kip2) from the Kip family. PMID:21359218

  9. Polo-like kinase 1 siRNA-607 induces mitotic arrest and apoptosis in ...

    African Journals Online (AJOL)



    Jul 13, 2011 ... Polo-like kinase 1 siRNA-607 induces mitotic arrest and apoptosis in human nasopharyngeal carcinoma cells. Jiang Zhu1, Huan Lan2,3, Suling Hong1*, Guohua Hu1, Qing Ai2,3, Zhengmei Yang2, Xia Ke1,. Fangzhou Song 2,3 and Youquan Bu2,3*. 1Department of Otolaryngology, The First Affiliated ...

  10. Prolonged mechanical ventilation induces cell cycle arrest in newborn rat lung.

    Directory of Open Access Journals (Sweden)

    Andreas A Kroon

    Full Text Available RATIONALE: The molecular mechanism(s by which mechanical ventilation disrupts alveolar development, a hallmark of bronchopulmonary dysplasia, is unknown. OBJECTIVE: To determine the effect of 24 h of mechanical ventilation on lung cell cycle regulators, cell proliferation and alveolar formation in newborn rats. METHODS: Seven-day old rats were ventilated with room air for 8, 12 and 24 h using relatively moderate tidal volumes (8.5⁻¹. MEASUREMENT AND MAIN RESULTS: Ventilation for 24 h (h decreased the number of elastin-positive secondary crests and increased the mean linear intercept, indicating arrest of alveolar development. Proliferation (assessed by BrdU incorporation was halved after 12 h of ventilation and completely arrested after 24 h. Cyclin D1 and E1 mRNA and protein levels were decreased after 8-24 h of ventilation, while that of p27(Kip1 was significantly increased. Mechanical ventilation for 24 h also increased levels of p57(Kip2, decreased that of p16(INK4a, while the levels of p21(Waf/Cip1 and p15(INK4b were unchanged. Increased p27(Kip1 expression coincided with reduced phosphorylation of p27(Kip1 at Thr¹⁵⁷, Thr¹⁸⁷ and Thr¹⁹⁸ (p<0.05, thereby promoting its nuclear localization. Similar -but more rapid- changes in cell cycle regulators were noted when 7-day rats were ventilated with high tidal volume (40⁻¹ and when fetal lung epithelial cells were subjected to a continuous (17% elongation cyclic stretch. CONCLUSION: This is the first demonstration that prolonged (24 h of mechanical ventilation causes cell cycle arrest in newborn rat lungs; the arrest occurs in G₁ and is caused by increased expression and nuclear localization of Cdk inhibitor proteins (p27(Kip1, p57(Kip2 from the Kip family.

  11. SPARC expression induces cell cycle arrest via STAT3 signaling pathway in medulloblastoma cells

    Energy Technology Data Exchange (ETDEWEB)

    Chetty, Chandramu [Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine at Peoria, One Illini Drive, Peoria, IL-61605 (United States); Dontula, Ranadheer [Section of Hematology/Oncology, Department of Medicine, University of Illinois College of Medicine at Chicago, 840 South Wood Street, Suite 820-E, Chicago, IL-60612 (United States); Ganji, Purnachandra Nagaraju [Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine at Peoria, One Illini Drive, Peoria, IL-61605 (United States); Gujrati, Meena [Department of Pathology, University of Illinois College of Medicine at Peoria, One Illini Drive, Peoria, IL-61605 (United States); Lakka, Sajani S., E-mail: [Section of Hematology/Oncology, Department of Medicine, University of Illinois College of Medicine at Chicago, 840 South Wood Street, Suite 820-E, Chicago, IL-60612 (United States)


    Highlights: Black-Right-Pointing-Pointer Ectopic expression of SPARC impaired cell proliferation in medulloblastoma cells. Black-Right-Pointing-Pointer SPARC expression induces STAT3 mediated cell cycle arrest in medulloblastoma cells. Black-Right-Pointing-Pointer SPARC expression significantly inhibited pre-established tumor growth in nude-mice. -- Abstract: Dynamic cell interaction with ECM components has profound influence in cancer progression. SPARC is a component of the ECM, impairs the proliferation of different cell types and modulates tumor cell aggressive features. We previously reported that SPARC expression significantly impairs medulloblastoma tumor growth in vivo. In this study, we demonstrate that expression of SPARC inhibits medulloblastoma cell proliferation. MTT assay indicated a dose-dependent reduction in tumor cell proliferation in adenoviral mediated expression of SPARC full length cDNA (Ad-DsRed-SP) in D425 and UW228 cells. Flow cytometric analysis showed that Ad-DsRed-SP-infected cells accumulate in the G2/M phase of cell cycle. Further, immunoblot and immunoprecipitation analyses revealed that SPARC induced G2/M cell cycle arrest was mediated through inhibition of the Cyclin-B-regulated signaling pathway involving p21 and Cdc2 expression. Additionally, expression of SPARC decreased STAT3 phosphorylation at Tyr-705; constitutively active STAT3 expression reversed SPARC induced G2/M arrest. Ad-DsRed-SP significantly inhibited the pre-established orthotopic tumor growth and tumor volume in nude-mice. Immunohistochemical analysis of tumor sections from mice treated with Ad-DsRed-SP showed decreased immunoreactivity for pSTAT3 and increased immunoreactivity for p21 compared to tumor section from mice treated with mock and Ad-DsRed. Taken together our studies further reveal that STAT3 plays a key role in SPARC induced G2/M arrest in medulloblastoma cells. These new findings provide a molecular basis for the mechanistic understanding of the

  12. Pulmonary emboli cardiac arrest with CPR complication: Liver laceration and massive abdominal bleed, a case report


    Lundqvist, John; Jakobsson, Jan G.


    Introduction: Massive pulmonary emboli may cause right ventricular failure and backward stasis with parenchymal organ swelling thus increasing the risk for laceration, e.g. if CPR is needed. Presentation of case: A 28-year-old Colombian female with no medical history but taking contraceptive pills and having had a recent longer flight was admitted to Danderyds hospital Emergency Department because of respiratory failure. She developed cardiac arrest in the emergence department following th...

  13. Arrested development – a comparative analysis of multilayer corona textures in high-grade metamorphic rocks


    Ogilvie, Paula; Gibson, Roger L.


    Coronas, including symplectites, provide vital clues to the presence of arrested reaction and preservation of partial equilibrium in metamorphic and igneous rocks. Compositional zonation across such coronas is common, indicating the persistence of chemical potential gradients and incomplete equilibration. Major controls on corona mineralogy include prevailing pressure (P), temperature (T) and water activity (aH2O) during formation, reaction duration (t) single-stage or seque...

  14. Cardiac arrest provoked by itraconazole and amiodarone interaction: a case report

    Directory of Open Access Journals (Sweden)

    Betrosian Alex


    Full Text Available Abstract Introduction Azoles, and specifically itraconazole, are often prescribed for the treatment of fungal diseases or empirically for persistent sepsis in patients who are neutropenic or in intensive care. Occasional cardiovascular adverse events have been associated with itraconazole use, and are usually attributed to the interaction of itraconazole with cisapride, terfenadine or digoxin. Its interaction with amiodarone has not been previously described. Case presentation A 65-year-old Caucasian man was admitted to the Intensive Care Unit at our facility for an extensive ischemic stroke associated with atrial fibrillation. Due to rapid ventricular response he was started on intravenous amiodarone and few days later itraconazole was also prescribed for presumed candidemia. After receiving the first dose our patient became profoundly hypotensive but responded rapidly to fluids and adrenaline. Then, two months later, itraconazole was again prescribed for confirmed fungemia. After receiving the first dose via a central venous catheter our patient became hypotensive and subsequently arrested. He was resuscitated successfully, and as no other cause was identified the arrest was attributed to septic shock and his antifungal treatment was changed to caspofungin. When sensitivity test results became available, antifungal treatment was down-staged to itraconazole and immediately after drug administration our patient suffered another arrest and was once again resuscitated successfully. This time the arrest was related to itraconazole, which was discontinued, and from then on our patient remained stable until his discharge to our neurology ward. Conclusions Itraconazole and amiodarone coadministration can lead to serious cardiovascular adverse events in patients who are critically ill. Intensivists, pharmacists and medical physicians should be aware of the interaction of these two commonly used drugs.

  15. Influence of Chest Compressions on Circulation during the Peri-Cardiac Arrest Period in Porcine Models.

    Directory of Open Access Journals (Sweden)

    Jun Xu

    Full Text Available Starting chest compressions immediately after a defibrillation shock might be harmful, if the victim already had a return of spontaneous circulation (ROSC and yet was still being subjected to external compressions at the same time. The objective of this study was to study the influence of chest compressions on circulation during the peri-cardiac arrest period.Prospective, randomized controlled study.Animal experimental center in Peking Union Medical Collage Hospital, Beijing, China.Healthy 3-month-old male domestic pigs.44 pigs (28±2 kg were randomly assigned to three groups: Group I (non-arrested with compressions (n = 12; Group II (arrested with compressions only (n = 12; Group III (ROSC after compressions and defibrillation (n = 20. In Groups I and II, compressions were performed to a depth of 5cm (Ia and IIa, n = 6 or a depth of 3cm (Ib and IIb, n = 6 respectively, while in Group III, the animals which had just achieved ROSC (n = 18 were compressed to a depth of 5cm (IIIa, n = 6, a depth of 3cm (IIIb, n = 6, or had no compressions (IIIc, n = 6. Hemodynamic parameters were collected and analyzed.Hemodynamics were statistically different between Groups Ia and Ib when different depths of compressions were performed (p < 0.05. In Group II, compressions were beneficial and hemodynamics correlated with the depth of compressions (p < 0.05. In Group III, compressions that continued after ROSC produced a reduction in arterial pressure (p < 0.05.Chest compressions might be detrimental to hemodynamics in the early post-ROSC stage. The deeper the compressions were, the better the effect on hemodynamics during cardiac arrest, but the worse the effect on hemodynamics after ROSC.

  16. Prehospital behaviour of patients admitted with acute coronary syndrome or witnessed cardiac arrest

    DEFF Research Database (Denmark)

    Ottesen, Michael Mundt; Dixen, Ulrik; Torp-Pedersen, Christian


    -four per cent of the patients admitted with cardiac arrest expressed no prior symptoms. Two-thirds of patients with typical symptoms interpreted it as cardiac-still only half took action within 20 min. Fifty per cent of patients who called a physician were delayed by wrong advice or misinterpretation. One...... for medical assistance. Perceiving jeopardy had positive influence on the behaviour. Awareness of therapeutic options influences the decision-making process....

  17. Genetic, clinical and pharmacological determinants of out-of-hospital cardiac arrest

    DEFF Research Database (Denmark)

    Blom, M T; van Hoeijen, D A; Bardai, A


    INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. Recognising the complexity of the underlying causes of OHCA in the community, we aimed to establish the clinical, pharmacological, environmental and genetic factors and their interactions that may cause OHCA...... victims since June 2005, we prospectively collect medical history (through hospital and general practitioner), and current and previous medication use (through community pharmacy). In addition, we include DNA samples from OHCA victims with documented ventricular tachycardia/fibrillation during...

  18. Research and application of measuring system for disconnector for surge arresters (United States)

    Chen, Ziyu; Luo, Xiaoyong


    This paper analyzes the current situation of the use of the disconnector for the arrester, and introduces the common faults and their causes. Based on the Labview programming environment, a low cost and convenient measurement system is developed to solve the problem of test trigger and waveform acquisition, which is aimed at the lack of electrical detection methods for small manufacturing enterprises in China. Finally, the system is applied to the actual production, and the performance of product are improved.

  19. Representative bureaucracy:does female police leadership affect gender-based violence arrests?


    Johnston, K.; Houston, John


    Representative bureaucracy theory postulates that passive representation leads to active representation of minority groups. This article investigates the passive representation of female police officers at leadership levels and the active representation of women vis-a-vis gender-based violence arrest rates in the UK. Much of the extant research on representative bureaucracy is located at street level, with evidence showing that discretionary power of minority bureaucrats can lead to active re...

  20. The problem of zombie cops in voodoo criminology: arresting the police patrol 100 yard myth


    Sutton, M; Hodgson, P


    The widely held criminological 'knowledge' that foot patrol beat policing is ineffective at either arresting offenders or reducing crime is substantially supported by research conducted by Clarke and Hough (1984), which makes the claim that: '...a patrolling policeman in London could expect to pass within 100 yards of a burglary in progress, roughly once every eight years but not necessarily catch the burglar or even realise that the crime was taking place.' This claim has been repeated, appa...